Vertebroplasty Surgery in Delhi, India

• The doctor asks about the brief medical history of the patient, followed by a physical examination to determine the exact location and nature of the pain. Apart from this, the doctor suggests imaging tests like CT-scan or MRI scans
• The patient is supposed to inform the doctor about all the medications and over-the-counter drugs
• Inform the doctor about any history of bleeding disorders
• Inform the doctor about the intake of any anti-coagulant like Aspirin
• The doctor instructs the patient not to wear any jewellery during the procedure
• It is always recommended to wear loose-fitting and comfortable clothing for undergoing this procedure
• Avoid eating meals at least 3 to 4 hours before the procedure

• The patient lies upside down on the table, and the doctor cleans the area of the spine and makes it ready for the procedure. Afterwards, general anaesthesia is administered on the area of the spine that has been marked.
• A needle is inserted through the skin surface and into the spinal vertebrae. Real-time x-ray images are used to guide the doctor to the correct area in your lower back and make sure to protect the body from radiation.
• Bone cement is slowly injected into the vertebra, and on the basis of how the cement enters the vertebra, the doctor might insert a second injection to fill it completely.

• The patient is made to lie on their back for a couple of hours by the time the cement hardens.
• The patient will likely remain in an observation room for an additional 1 to 2 hours.
• The patient may experience pain relief almost immediately after the procedure, but it might take up to 3 to 4 days. The doctor can provide the patient with over-the-counter analgesics for temporary relief.
• The doctor will monitor the condition and assess the pain and check for any possible complications.
• The patient may need to continue wearing a back brace, but it's usually unnecessary.
• The patient will come back for a follow-up appointment in a few weeks.

• Cement leakage, no bleeding as it is done by a needle.
  

The complications of vertebroplasty can be classified as mild, moderate and severe.

Mild complications of Vertebroplasty

• Temporary increase in pain post vertebroplasty
• Transient arterial hypotension
• Bone cement leakage into the intervertebral disc space
• Increased risk for new fractures

Moderate complications of Vertebroplasty

• Infection
• Leakage of bone cement into the areas of epidural or foraminal space
• Misplaced needle in the tract

Severe complications of Vertebroplasty

• Leakage of bone cement into the paravertebral veins
• Pulmonary embolism
• Cardiac perforation
• Cerebral embolism
• Liquid consistency of the bone cement
• Radicular pain

Techniques to minimize complications

• Selecting a transpedicular route in the lumbar spine and costovertebral junction in the thoracic spine.
• Avoiding a cortical breach whenever possible.
• Optimizing opacification of cement by following the manufacturer's recommendations and not altering recommended proportions of powder polymer and liquid polymer.
• Defining optimal cement viscosity before injection. If cement leakage occurs, cessation of the procedure is recommended.

Reviewed by Dr. Priyank Uniyal, Consultant - Spine Surgery on 14-Sep-2022

What is vertebroplasty?
Vertebroplasty treats vertebral compression fractures (VCFs) by injecting bone cement into the fractured vertebra.

When is vertebroplasty recommended?
Vertebroplasty is recommended for patients with painful VCFs, often caused by osteoporosis, spinal tumours, or trauma.

Is vertebroplasty the same as kyphoplasty?
No, vertebroplasty and kyphoplasty are similar but have different techniques. Vertebroplasty involves injecting cement directly into the fractured vertebra, while kyphoplasty uses a balloon to create space before cement injection.

What are the benefits of vertebroplasty?
Vertebroplasty can relieve pain, stabilize the spine, and improve mobility for patients with VCFs.

What are the potential risks and complications of vertebroplasty?
Risks include infection, bleeding, cement leakage, nerve injury, and allergic reactions to the cement.

Can vertebroplasty be performed as an outpatient procedure?
Yes, vertebroplasty is often done as an outpatient procedure, allowing patients to go home the same day.

Is vertebroplasty suitable for all VCFs?
Vertebroplasty is typically reserved for symptomatic VCFs that have not responded to conservative treatment.

Can a patient with a history of VCFs undergo multiple vertebroplasty procedures?
Yes, multiple vertebroplasty procedures may be performed if new fractures occur.

Is vertebroplasty an option for patients with spinal metastases?
Vertebroplasty can be used to manage painful spinal metastases by stabilizing affected vertebrae.

What is the recovery time after vertebroplasty?
Recovery is usually rapid, with patients experiencing pain relief within days to weeks after the procedure.

Can a patient with a history of vertebroplasty develop new compression fractures?
Yes, while vertebroplasty stabilizes fractured vertebrae, it does not prevent new fractures from occurring.

Are there alternatives to vertebroplasty for VCF treatment?
Kyphoplasty, bracing, pain management, and physical therapy are alternative treatments for VCFs.

Is vertebroplasty a long-term solution for VCFs?
Vertebroplasty provides long-term pain relief and spinal stability, but additional fractures may occur over time.

Can vertebroplasty be performed in patients with severe osteoporosis?
Yes, vertebroplasty is often used to manage VCFs in patients with severe osteoporosis.

Is vertebroplasty suitable for pediatric patients with VCFs?
Vertebroplasty is rarely performed in pediatric patients and is typically considered for adults with VCFs.

Can vertebroplasty be performed on multiple vertebrae in one session?
Yes, multiple vertebroplasty procedures can be performed during a single session if needed.

Can a patient with a history of vertebroplasty develop spinal cord compression?
Spinal cord compression can occur in some cases, but it is not directly related to vertebroplasty.

Is vertebroplasty used in the treatment of osteolytic spinal lesions in multiple myeloma?
Yes, vertebroplasty can provide pain relief and stabilize vertebrae in multiple myeloma patients.

Can vertebroplasty be performed with local anaesthesia?
Vertebroplasty is typically performed under local anaesthesia with sedation to keep the patient comfortable.

Is it possible for a patient to develop allergies to the bone cement used in vertebroplasty?
Allergic reactions to bone cement are rare, but they can occur, and patients should inform their healthcare providers of any allergies.

Can a patient with a history of vertebroplasty experience cement leakage into the spinal canal?
Cement leakage is a known complication, and measures are taken during the procedure to minimize the risk.

Can vertebroplasty be performed in patients with spinal cord injuries?
Vertebroplasty is typically not used to treat spinal cord injuries but may be considered for associated VCFs.

Is vertebroplasty a common procedure in elderly patients with VCFs?
Vertebroplasty is commonly performed in elderly patients with VCFs, particularly those with osteoporosis.

Can a patient with a history of vertebroplasty develop other spine-related conditions later in life?
Patients should continue regular follow-ups with vertebroplasty doctors to monitor for other spine-related conditions.

Review

FAQs reviewed by Dr. Kapil Jain - Principal Consultant – Neurosurgery, Neurosciences, Spine Surgery, Paediatric (Ped) Neurosurgery