A vertebroplasty is an injection of bone cement into a fractured vertebra. Many people in their lifetime may sometimes experience a compression fracture of the vertebra, one of the many bones in the spine. These can be due to osteoporosis, traumatic injury, cancer involving the spine, or other causes. These fractures can be very painful and sometimes, progression of the fracture can affect other functions of the body, like good posture or proper breathing. A vertebroplasty, the injection of a small amount of cement through a needle into the fracture, can stabilize the fracture, significantly reduce pain, and prevent progression of the fracture in the future.
How long does this procedure take?
The procedure takes about an hour. After the procedure, you will need to lie still as the bone cement hardens.
Allow three hours for the procedure; this will include talking to your doctor before the procedure, signing the informed consent, positioning in the room, and observation by the recovery room nurse afterwards.
What is injected?
The injection consists of a mixture of local anesthetic in the skin and deep tissues, and bone cement into the fracture.
Will the procedure hurt?
Our procedures begin by injecting a small amount of local anesthetic through a small needle. It feels like a little pinch and then a slight burning as the local anesthetic starts numbing the skin. After the skin is numb, the procedure needle feels like a bit of pressure at the injection site. If you experience any pain during the procedure, your doctor will inject more local anesthetic as needed.
Will I be "put out" for this procedure?
You will be mildly sedated for this procedure. You will be awake enough to communicate with your doctor.
How is this procedure performed?
This procedure is done with you lying on your stomach. Your blood pressure and oxygenation will be monitored. An intravenous line will be started and you will receive antibiotics through it.
In addition to your doctor and the x-ray technician, there will be a nurse in the room at all times if you have any questions or discomfort during the procedure. The skin in the back is cleaned with antiseptic solution and then the procedure is done. During the procedure, you will feel the pressure of the needle being placed. If it becomes painful, let your doctor know at once and more local anesthetic can be added or more sedation can be given. You may feel a slight tapping sensation. This is normal also. If any of these sensations make you feel uncomfortable, inform your physician.
What should I expect after the injection?
After the procedure, you will be taken to the recovery room. You will lay still for an hour or more. Your vital signs will be monitored. The recovery room nurse will periodically have you wiggle your toes and move your legs. Your pain relief will start right away.
What should I expect after the injection?
We advise the patients to take it easy for a day or two after the procedure. Your recovery room nurse will advise you about applying ice to the site and the limits on activity for a few days after the procedure.
Can I go back to work the same day?
No. Since sedation is used during the procedure, you should go home and rest. Your doctor or recovery room nurse will discuss this with you.
How long do the effects of this procedure last?
The cement is permanent. Whether or not you obtain complete pain relief will depend on what other pain generators you have in the area. Your doctor will discuss this with you.
How many injections do I need?
A vertebra needs only one injection. You may need additional injections if fractures in other vertebrae are discovered.
How will I know if this procedure will help?
It is difficult to predict how helpful injections will be. Patients with severe back pain near the fracture site with minimal radiating pain from the site do very well. There are other pain generators in the area. In addition to the compression fracture, the patient may have pain from inflamed facet joints, bulging disks, or other problems. Your doctor will do this procedure only if the fracture is somewhat recent (usually occurring within the previous six months) and an MRI confirms the presence of inflammation at the fracture site.
What are the risks and side effects?
This procedure has few risks. As with any procedure, there are some risks and side effects you should know about. Your doctor will discuss this with you in detail. Commonly encountered side effects are increased pain from the injection (usually temporary), inadvertent puncture of the "sack" containing spinal fluid (may cause headaches), infection, bleeding, nerve damage, or no relief from your usual pain.
Who should not have this injection?
The following patients should not have this injection: if you are allergic to any of the medications to be injected, if you are on a blood-thinning medication (e.g. coumadin, injectable heparin), or if you have an active infection.