Vertebroplasty Surgery in Noida, Delhi, India

Overview

Vertebroplasty is a minimally invasive procedure designed to address compression fractures in the spine. In this procedure, medical-grade bone cement is injected into the fractured vertebra, which hardens and stabilizes the bone, reducing pain and improving mobility. The primary goal is to alleviate the patient’s discomfort and restore their ability to carry out daily activities.

This procedure is most commonly recommended for patients who have not responded well to conservative treatments such as bed rest, pain medications, braces, or physical therapy. It is also suggested in cases where vertebral fractures result in complications such as deep vein thrombosis, severe osteoporosis, or respiratory issues.

Preparation for Vertebroplasty Surgery

Before undergoing vertebroplasty, patients are prepared through the following steps:

• Medical History and Physical Exam: The doctor will review the patient’s medical history and conduct a physical examination to identify the location and severity of the pain. Imaging tests, including X-rays, CT scans, or MRIs, may be recommended.
• Medication Review: Patients should inform their doctor about any medications they are taking, including prescription drugs, over-the-counter medications, or supplements.
• Bleeding Disorders: It’s essential to notify the doctor if there is any history of bleeding disorders.
• Blood Thinners: The patient must inform the doctor if they are taking blood thinners such as aspirin, as these may need to be stopped before surgery.
• Jewelry Removal: Patients should avoid wearing any jewelry on the day of surgery.
• Clothing: Loose-fitting and comfortable clothing is recommended for the procedure.
• Fasting: Patients are typically instructed not to eat or drink for 3 to 4 hours before the surgery.

During the Vertebroplasty Procedure

• Positioning: The patient lies face down on the surgical table, and the area around the spine is thoroughly cleaned.
• Anesthesia: Local anesthesia is given to numb the targeted area.
• Needle Insertion: A needle is guided through the skin into the fractured vertebra using real-time X-ray imaging (fluoroscopy) to ensure precise placement.
• Cement Injection: Medical-grade bone cement is injected into the vertebra. Depending on how the cement spreads, a second injection may be required to fill the fracture completely.

After the Vertebroplasty Procedure

• Recovery: The patient will be asked to lie flat for 1 to 2 hours until the cement hardens.
• Observation: Patients typically remain in an observation room for 1 to 2 hours before being discharged.
• Pain Relief: Most patients experience significant pain relief within a few days, though some may feel immediate relief. Over-the-counter pain medications may be prescribed for temporary discomfort.
• Follow-up: The patient will need to return for a follow-up appointment to monitor their recovery and check for any potential complications.

Risks and Complications of Vertebroplasty Surgery

While vertebroplasty is generally a safe and effective procedure, there are potential risks, which occur in about 1% to 3% of patients. These include:

• Cement Leakage: Bone cement may leak into surrounding areas, although this rarely causes symptoms.
• Infection: Like any surgical procedure, there is a small risk of infection.
• New Fractures: There is an increased risk of new fractures in adjacent vertebrae due to the stabilization of the treated vertebra.
• Misplaced Needle: The needle may be inadvertently placed outside the target vertebra, requiring adjustment.
  Mild to Severe Complications

Mild Complications:

• Temporary increase in pain post-surgery
• Transient arterial hypotension
• Bone cement leakage into the intervertebral disc space

Moderate Complications:

• Infection
• Cement leakage into the epidural or foraminal space
• Needle misplacement

Severe Complications:

• Cement leakage into paravertebral veins, potentially causing pulmonary embolism, cardiac perforation, or cerebral embolism.

Minimizing Complications

To reduce the risk of complications, the following techniques are often employed:

• Accurate Needle Placement: Using a transpedicular approach in the lumbar spine and a costovertebral approach in the thoracic spine.
• Preventing Cement Leakage: The cement viscosity is optimized before injection, and the procedure is halted if leakage is detected.
• Cement Preparation: Following the manufacturer’s recommendations for mixing cement to ensure the correct consistency.
  Benefits of Vertebroplasty Surgery
• Pain Relief: Many patients experience significant pain relief within 48 hours of the procedure.
• Improved Mobility: Patients can often return to their normal activities shortly after the surgery.
• High Satisfaction: Vertebroplasty has a high success rate, with most patients reporting substantial improvements in their quality of life.

Frequently Asked Questions

What is vertebroplasty?

Vertebroplasty is a surgical procedure to treat vertebral compression fractures (VCFs) by injecting bone cement into the fractured vertebra.

When is vertebroplasty recommended?

It is recommended for patients with painful VCFs, commonly caused by osteoporosis, spinal tumors, or trauma, who haven’t responded to conservative treatments.

Is vertebroplasty the same as kyphoplasty?

No. Vertebroplasty involves injecting cement directly into the fractured vertebra, whereas kyphoplasty uses a balloon to create a cavity before cement injection.

What are the benefits of vertebroplasty?

The procedure relieves pain, stabilizes the spine, and restores mobility in patients with vertebral fractures.

What are the risks and complications?

Risks include infection, bleeding, cement leakage, and nerve injury, though they are rare.

Can vertebroplasty be done as an outpatient procedure?

Yes, most vertebroplasties are performed on an outpatient basis, allowing patients to go home the same day.

Is vertebroplasty suitable for severe osteoporosis patients?

Yes, it is often used to manage VCFs in patients with severe osteoporosis.

What is the recovery time?

Most patients experience pain relief within days to weeks, and recovery is typically rapid.

Can multiple vertebroplasties be performed in one session?

Yes, if needed, multiple fractures can be treated during a single session.

Are there alternatives to vertebroplasty?

Alternatives include kyphoplasty, bracing, physical therapy, and pain management.

Reviewed by Experts

• Reviewed by: Dr. Akash Mishra – Sr. Consultant, Brain & Spine Surgeon, 14-Sep-2024
• FAQs Reviewed by: Dr. Anutosh Singh – Sr. Consultant, Brain & Spine Surgeon