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Why has my doctor ordered this procedure?
Percutaneous vertebroplasty is a therapeutic injection procedure under x-ray guidance which consists of the injection of bone cement into a vertebral body (the bones in your spine) for the relief of pain and the strengthening of bone, most commonly to alleviate symptoms associated with osteoporotic compression fractures. The concept of replacing a diseased vertebral body with bone cement has been around for a long time. Traditionally, this procedure has been done through a surgical incision with a quite long recovery time but in generally is rarely done for osteoporotic compressive fractures. With the invention of vertebroplasy, bone cement can be injected in the affected vertebrae without surgery. The first vertebroplasty was performed in France in 1984, and has been done in the United States since 1993.

What will happen during the procedure?
Once positioned appropriately by your doctor, a fluoroscope (X-ray guidance machine) assists in identifying the painful vertebral body. Prior to the procedure you usually will have an C-ray of the affected area, and possibly other tests such as an MRI and bone scan. The area is then cleansed and the skin is numbed. A special needle is inserted under x-ray guidance into the vertebral body. You will receive sedation throughout the procedure, but you will need to be able to communicate with your physician throughout the procedure. You will also receive some preoperative antibiotics. Depending on the technique used, either one or two needles will be placed in the vertebral body. Once the needle is in an appropriate position some dye will be injected to ensure appropriate placement of the needle tip. Then the bone cement will be mixed and slowly injected into the vertebral body. The bone cement hardens within less than half an hour. The needle will be removed and you will be taken to the recovery area, where you will usually be observed for about two hours. Some patients feel some significant pain improvement by the time they leave the hospital; for others it may take up to a week or so.

What are the associated risks?
In general, this procedure is a safe procedure when performed with appropriate technique. Like all injections, there is a small risk of bleeding, infection, or allergic reaction. Back pain may come from many different sources. Vertebroplasty will usually relieve the pain from compression fractures, but may not affect other causes of back pain.

More specific risks associated with this procedure are allergic reaction to the contrast, rib or pedicle fractures, pneumothorax (puncture of the lung), pulmonary embolization to the veins or lungs, osteomyelitis (infection of the bone), worsening pain, paralysis (loss of function of your legs) or loss of bowel or bladder function. These complications are rare, but could conceivably occur.

You will be asked to report any allergies at the time your injection is scheduled. This information is necessary for your doctor to know in advance.

Be aware that the local anesthetic and sedation medicine will take several hours to wear off. It is imperative to have someone drive you home. It is advised that you only slowly advance your activity level after the procedure. Advancing your activity too much may increase the risk of fractures in other parts of your spine. Please make sure to contact your physician about your appropriate post-procedure rehabilitation program. It is also necessary that you receive appropriate treatment for osteoporosis if you suffer from this condition.

If you have any concerns or questions please discuss them with your doctor.