A vertebral compression fracture is when one or more of the spinal bones (vertebrae) breaks and collapses. More often than not, the fracture is linked to osteoporosis, a disease in which bones become thin and weak due to a depletion of calcium. The vertebrae in the lumbar spine (lower back) are the bones most commonly affected, but vertebrae in any part of the spine can break.
Compression fractures can lead to nerve damage, severe back pain (especially in the middle and lower back), loss of height, a stooped posture, and trouble walking. In extreme cases, patients are confined to bed.
Vertebroplasty is an outpatient procedure offered by Advanced Pain Consultants, which uses a medical-grade cement to repair and stabilize broken and collapsed vertebrae. The goal is to reduce pain and restore function to the patient’s spine, allowing him or her to return to normal activity. This procedure can also prevent further complications from compression fractures, including spinal deformity and height loss.
The best candidates for vertebroplasty are people who have recently suffered a vertebral compression fracture and are having moderate to severe back pain. Typically, more conservative treatments (bed rest, back brace and pain reliever medications) have been tried but have not relieved the pain.
In most cases, compression fractures are associated with osteoporosis, but they may also be caused by the following:
Vertebroplasty is most effective in patients who undergo this treatment within the first two weeks after their fracture. This procedure is not usually helpful for old compression fractures or chronic back pain, nor will it improve back pain associated with poor posture, herniated intervertebral discs, severe arthritis, or compression of the spinal cord or nerve roots.
Not all patients with recent vertebral compression fractures are good candidates for vertebroplasty. This procedure is generally not recommended for people with bleeding disorders, bone infections (osteomyelitis), fracture fragments or tumors in the spinal canal, or allergies to the drugs used in the treatment.
Before undergoing vertebroplasty, Dr. Pasi requires patients to undergo a clinical evaluation and a physical examination, followed by imaging tests such as spine X-rays, bone scans and magnetic resonance imaging. This helps Dr. Pasi identify candidates for this procedure, and also helps her determine where the fracture sites are and when they occurred.
The procedure an be performed in our office or in an outpatient surgical center. It can take anywhere from 30 minutes to two hours to do, depending on how many bones are treated. Dr. Pasi starts by injecting a local anesthetic into the treatment area, and then makes a small incision in the skin over the fractured bone. She then inserts the needle through the incision and into the fractured vertebra using a fluoroscope (a special x-ray machine which provides continuous imaging) for guidance.
Once Dr. Pasi has confirmed the needle is in the correct position, she will inject stabilizing acrylic cement into the fractured areas of the bone. She will verify that the cement has been evenly distributed, and then withdraw the needle. Within 15 minutes the cement will harden, and this will stabilize the fracture, like an internal cast. The incision will be closed with stitches, and a bandage may be placed over the area where the procedure was done.
Recovery time is relatively quick. Most patients are sent home the same day and are walking almost immediately after the procedure. Dr. Pasi generally recommends bed rest for the 24 hours following the procedure for proper healing and to ensure the cement completely sets. Most patients are able to resume their normal activities within 24 to 48 hours after vertebroplasty.
Vertebroplasty successfully relieves pain and restores mobility in 75 to 90 percent of patients. Usually the positive results of the treatment starts taking effect within 24 to 72 hours, although some patients report significant pain relief a soon as 2 to 3 hours after the procedure. Surgical complications are uncommon, affecting no more than 1 to 3 percent of patients.
In general, the sooner a fracture is repaired, the better the results. To maximize your recovery, Dr. Pasi will recommend physical therapy and exercises to help you strengthen your spine and core muscles in your back. This can help prevent compression fractures from occurring again in the future.
Determining if your specific condition will improve with vertebroplasty will require a full consultation. Dr. Pasi will conduct a battery of tests using state-of-the-art medical imaging devices to determine the presence of compression fractures in your spine and then make a recommendation for treatment. Please call Advanced Pain Consultants today at (919) 510-7901 to make an appointment to speak with Dr. Pasi about your spine symptoms and possible treatment options.