Vertebroplasty
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- Vertebroplasty can provide pain relief for patients with fractures of the spine resulting from osteoporosis (thinning of bone) and tumor.
- A needle is placed into the compressed vertebral body under x-ray guidance and medical grade cement is injected through the needle under x-ray guidance to stabilize the fracture and provide pain relief.
- Vertebroplasty is not effective for patients with disc disease, spinal stenosis, or fractures occuring outside of the spine.
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Painful vertebral body collapse can result from multiple causes including osteoporosis (thinning of bone), bone tumors, multiple myeloma, and abnormal blood vessels. The most common cause is osteoporosis, resulting in 700,000 compression fractures and 115,000 hospital admissions annually. The lifetime risk of vertebral compression fracture is 16% for white women and 5% for white men with overall higher risk for Asian-Americans and lower risk for African-Americans. These fractures are often accompanied by chronic pain, loss of mobility and loss of ability to perform activities of daily living.
Percutaneous vertebroplasty, first performed by the French in the mid-1980s, positions a needle into the vertebral body under x-ray guidance and polymethylmethacrylate cement is injected into the vertebral body. Filling of the vertebral body with cement has been demonstrated to be an effective treatment for fracture pain and stabilization the vertebral body. This often results in improved mobility and prevention of further vertebral body collapse. In the United States, the first vertebroplasty was performed in 1993 by Dr. Jacques Dion, chief for Emory's division of interventional neuroradiology and Dr. Mary Lee Jensen. Since then, vertebroplasty has gained increasing acceptance in the United States primarily for treating osteoporotic compression fractures.
Various vertebroplasty studies demonstrate pain relief in 80-95% of properly selected patients. Typically, pain relief is obtained within 7 days following completion of the procedure, with some patients obtaining improvement of symptoms immediately following completion of the procedure. Significant complications occur in 1% of patients treated for osteoporosis and 5-10% for patients with spine tumors. These complications can include spinal cord/nerve compression, cement deposition in the lungs (pulmonary embolism), new fracture resulting from needle placement, and infection.
In summary, percutaneous vertebroplasty is an effective outpatient procedure with a low overall complication rate for properly selected patients. The resulting pain relief and vertebral body stabilization can have a dramatic effect on the well-being of these patients, many of whom are able to discontinue analgesic therapy and resume activities of daily living.
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