Vertebroplasty

Vertebroplasty and Kyphoplasty are two modern surgical procedures that are used to help to rebuild the height or the vertebral bones and to halt the destruction of them due to microfractures. While many types of joints surgeries are designed to protect the structures of the spinal cord and nerve roots, the Vertebroplasty procedure is designed specifically to create stability of the spinal bones themselves. If the verterboplasty procedure is successful, it may be able to slow the progression or reverse the progression of lordosis and kyphosis, an abnormal vertical curvature of the spine, as well as back pain associated with compression fractures of the vertebrae.

A compression fracture is likely to affect the weight bearing section of the vertebrae (the body). With compression, the combination of time and loss of bone density, the repeated weight and shocks may weight down on the spinal to the point where tine breaks and cracks develop. If the compression fractures are not corrected or the cause is not treated, the breaks and fissures in the bone may advance to the point where the bone buckles forward. These types of fractures are one of the most common causes for kyphosis, or the hunched forward posture you see in elderly men and women. Compression fractures are also one of the primary reasons for the loss of height due to age advancing.



Why they're done: Doctors who prescribe and treat with the vertebroplasty procedure think that they can slow the progression of the destruction of the bone, by injecting the fissures and cracks inside with a synthetic substance. This synthetic substance, an injected liquid substance that hardens like cement, may be able to actually build back some of the lost height of the bone back to its previously healthy size.

How they're done: The vertebroplasty procedure is performed by doctors in an outpatient clinic, usually by orthopedic surgeons or specialists called interventional radiologists. This team of radiologists and surgeons will use the available technology to guide the needle injecting the cement-like material into place and into the affected vertebrae responsible for back pain, neck pain, or other spinal instability. The operation is minimally invasive, first requiring a small incision over the vertebrae involved in the procedure. Next, a needle with about the diameter of a cocktail straw is inserted directly into the fractured vertebrae. The doctor will use medical imaging equipment to guide the needle into the correct position inside the vertebral bone.

Because of the small keyhole required to insert the needle, the patient is able to leave the office only a few hours after the procedure. Patients only require a small sedative during the procedure itself.

Prognosis: The vertebroplasty and kyphoplasty procedures may both be effective in restoring the stability and function of vertebral bones to healthy functioning, that do not heal on their own after compression fractures. Many patients with compression fractures in the spinal bones are responsive to treatments for osteoporosis, which is one of the most common causes of compression fractures, but some are not. This procedure may help patients with compression fractures that do not respond well to treatments for osteoporosis, including drugs like Miacalcin, Fortical, and Evista. Both procedures are relatively new, and have less data as to their long-term effectiveness, compared to other back pain surgeries.