Vertebroplasty
Vertebroplasty is a pain treatment for vertebral compression fractures that fail to respond to conventional medical therapy, such as minimal or no pain relief with analgesics or narcotic dose that are intolerable. Vertebroplasty, a non-surgical treatment performed at Saint Anthony's Center for Pain Management, uses imaging guidance by interventional radiologists, stabilizing the collapsed vertebra with the injection of medical-grade bone cement into the spine. This improves pain, and can prevent further collapse of the vertebra, thereby preventing the height loss and spine curvature commonly seen as a result of osteoporosis.
Vertebroplasty dramatically improves back pain within hours of the procedure, provides long-term pain relief and has a low complication rate as demonstrated in multiple studies. Vertebroplasty was performed in France in 1984 to treat compression fractures caused by bone cancer or bone metastasis, and later to treat compression fractures caused by osteoporosis. Percutaneous vertebroplasty was introduced in the United States in 1984 and has become widely available since 1997 as a treatment for pain relief for osteoporosis.
Fractures of the vertebra have traditionally been much more difficult to manage than broken bones in the hip, wrist or elsewhere. These broken bones can often be successfully treated with surgery. But because surgery on the spine is extremely difficult and risky, it has typically not been used to treat vertebral fractures associated with osteoporosis except as a last resort. Until recently, reduced activity and pain medications, many of which cause problematic side effects, or invasive (and often unsuccessful) back surgery were virtually the only treatments available.
Today, however, Vertebroplasty is a safe, non-surgical interventional radiology treatment called vertebroplasty that has been shown to be extremely effective in reducing or eliminating the pain caused by spinal fractures.
The procedure has been shown to provide continued pain relief for osteoporotic compression fractures. A 1998 study reported on 80 patients with rapid and complete pain relief in more than 90 percent of osteoporotic cases. The follow-up in this patient population ranged from one month to 10 years with evidence of prolonged pain relief. Vertebroplasty is likely to become a standard of care for treating osteoporotic compression fractures as more patients and physicians become aware of the new advances in interventional radiology.
Vertebroplasty is an outpatient procedure using x-ray imaging and conscious sedation. The interventional radiologist inserts a needle through a nick in the skin in the back, directing it under fluoroscopy (continuous, moving x-ray imaging) into the fractured vertebra. The physician then injected the medical-grade bone cement into the vertebra. Vertebroplasty takes from one to two hours to perform depending on how many bones are treated. The cement hardens within 15 minutes and stabilizes the fracture, like an internal cast.
Some patients experience immediate pain relief after vertebroplasty. Most report that their pain is gone or significantly better within 48 hours. Many people can resume their normal daily activities immediately.
Q: Is the procedure safe?
A: Vertebroplasty is very safe. Although it is a relatively new treatment in the U.S. Vertebroplasty has been performed for more than a decade at several centers in France with excellent results. the injection technique also has been successfully used for a number of years in the U.S. to treat other conditions in the spine. Such as cancer and blood vessel abnormalities. The bone cement used to stabilized the fractured vertebrae has been shown to be safe through many years of use in joint replacement surgeries and other orthopedic procedures.
Q: Who is a candidate for vertebroplasty?
A: People who have suffered recent compression fractures that are causing them moderate to severe back pain are the best candidates for vertebroplasty. In some cases, older fractures may be treated, but the procedure is most successful if it is performed soon after the fracture occurs. The procedure is not used to treat chronic back pain or herniated disks.
Q: How successful is vertebroplasty?
A: Studies have shown that from 75 percent to 90 percent of people treated with vertebroplasty will have complete or significant reduction of their pain.
Q: What are the risks or complications?
A: Vertebroplasty is a very safe procedure with few risks or complications. In many studies, no complications were reported. As with any medical procedure, the possibility of complications will depend on individual patient conditions. you should always ask your doctor to discuss risks and complications with you before you undergo any procedure.
For more information on Saint Anthony's Center for Pain Management, please call: 618/474-4866.