Vertebroplasty: A nonsurgical method for the repair of vertebral fractures and compression due to osteoporosis.
Broken bones in the spine are often due to osteoporosis, the progressive loss of bone tissue, which depletes both the collagen and the calcium salts from bone so the bone then becomes weaker and more prone to fractures by cracking or by collapsing (compression). People with osteoporosis rarely have symptoms until the bone fractures occur. When this results in compression of bony building blocks of the spine (vertebrae) it can collapse the vertebrae much like a sponge collapses under the pressure of one's hand. A fracture that collapses a spinal vertebra in this way called a vertebral compression fracture. Although they may occur without pain, vertebral fractures often cause a severe "band-like" pain that radiates from the spine around both sides of the body. Over many years, spinal fractures lessen the height of the spine and the person becomes shorter. The treatment of vertebral compression fractures was long limited to taking pain medicine, resting, avoiding injury, and bracing.
Vertebroplasty was first developed in France. The technique is performed by a radiologist without surgery and involves inserting a glue-like material into the center of the collapsed spinal vertebra in order to stabilize and strengthen the crushed bone. The glue (methylmethacrylate) is inserted with a needle and syringe through anesthetized skin into the midportion of the vertebra under the guidance of specialized x-ray equipment. Once inserted, the glue soon hardens, forming a cast-like structure with the broken bone. Relief of pain comes quickly from a casting effect on the broken bone and the newly hardened vertebra are then protected from further collapse.
The advantages of vertebroplasty, aside from prompt pain relief, include better mobility. (Often patients with new vertebral fractures can't even sit up without worsening the severe pain and the inactivity contributes to further osteoporosis). Vertebrae that have collapsed to less than 30% of their normal height are poor candidates for this procedure. Complications related to these procedures have been reported in the literature and to the FDA (the US Food & Drug Administration). Some reported complications, such as soft tissue damage and nerve root pain and compression, are related specifically to the leakage of bone cement. Other reported complications include pulmonary embolism, respiratory and cardiac failure, and death.
Kyphoplasty is a related technique. |
