What is Vertebroplasty?

Percutaneous Polymethylmethacrylate Vertebroplasty is a minimally invasive outpatient procedure that uses orthopedic cement to create an internal splint within fractured vertebrae. Under x-ray guidance, the physician inserts one or two needles into the fractured vertebrae through the skin of the back. A small amount of opacified cement (about ¼ ounce) is then injected into the vertebral bodies, and the needle is removed.

Who is a candidate?

The primary indication for vertebroplasty is to treat the pain associated with pathologic vertebral body fractures. The most commonly treated fractures are those related to bone loss and osteoporosis in the elderly, however vertebroplasty can also be used to treat vertebrae that are fractured due to infiltration by benign or malignant tumors, or fractures that occur in patients taking high doses of steroids such as those with lupus, scleredema, asthma, or chronic obstructive pulmonary disease.

How would a vertebroplasty help me?

Vertebroplasty helps patients by providing almost immediate relief of pain related to vertebral compression fractures. Instead of spending weeks in bed hoping to recover from a fracture, patients can often return to normal activities within only two or three days of having a vertebroplasty performed. Increased activity can help prevent serious or fatal complications of bed rest such as pneumonia, or pulmonary embolism from blood clots in the legs. Vertebroplasty has also been shown to improve the psychosocial wellbeing of patients suffering from painful vertebral compression fractures.

How long does the procedure take?

Vertebroplasty takes about one half-hour to perform for each treated level. The total time spent in the x-ray room is usually about one hour.

How long is the hospital stay?

We require our patients to remain in the Radiology Holding Area for about three hours after vertebroplasty. After three hours, the patient is typically allowed to return home in the company of their family or a caretaker. Arrangements should be made for a driver and transportation.

Will I have immediate pain relief?

A large percentage of patients, perhaps even more than half, will report immediate relief of pain in the first few hours after the procedure. Most patients do report some local bruising and tenderness of the back for the first 48 to 72 hours after the procedure, but by the third post-operative day, 80 to 90 percent will report substantial or complete pain relief.

Should I be worried about the long-term effects of bone cement?

The acrylic cement that is used to perform vertebroplasty has been available for approximately four decades. Methacrylate is used extensively in orthopedic surgery for various uses. It is used to join the components of hip and knee replacements to normal bone. No long term detrimental effects of bone cement have been demonstrated.

What is the success rate of the procedure?

The most recent studies report an 80 to 90 percent success rate in substantially or completely relieving patients. pain. In addition, there are statistically significant improvements in psychosocial wellbeing and functional disability. The complication rate has been extremely low.

Where can I go do get this procedure?

Most physicians who perform vertebroplasty are radiologists, particularly Neuroradiologist. An increasing number of orthopedists, neurosurgeons and anesthesiologists (pain management physicians) have begun to perform vertebroplasty in the last few years. Most university hospitals, and even large community hospitals, may have a radiologist who performs the procedure, however, the most experienced physicians are still typically in university practices.

Is this procedure covered by Medicare?

Vertebroplasty is now covered by Medicare in many states, and is expected to be covered nationwide by 2001.

Is this procedure covered by private insurance?

Most private insurers will cover vertebroplasty. Check with your individual carrier for details.