May2023

Patient BlogSpine Surgery

The procedure carried out by neurosurgeons is performed for patients struggling with pathological vertebral fractures, hemangiomas, cancer metastases and herniated discs. It is believed that vertebroplasty can help with spinal pain, so it is worth knowing what this treatment method involves. What are the indications for the procedure and how does it proceed? Are there any requirements to prepare for vertebroplasty? The most important information about this method used to help treat spinal pain is presented in the following article.

Indications for vertebroplasty

The procedure is performed for patients struggling with chronic pain caused by compression fractures of the vertebral bodies resulting from trauma or in the course of osteoporosis. Such damage can lead to loss of growth and angular deformities and caused by progressive vertebral collapse. This procedure is also recommended for multiple fractures and those located at the thoracolumbar junction. Other indications for vertebroplasty include aggressive hemangioma, cancer metastases from other organs and spinal herniation.

If the patient’s complaints cause severe pain that cannot be relieved with medication or stabilisation with a corset and limits the ability to function on a daily basis, then surgery is recommended.

How does spinal surgery work?

Vertebroplasty is a minimally invasive treatment where special cement is injected into the damaged bone to help relieve pain. The procedure is performed with anaesthesia, the exact type of which depends on the nature of the procedure, as well as its extent. A general option can be used, but local is the most common choice.

During vertebroplasty, the patient lies on their abdomen and first receives anaesthetic injections. The neurosurgeon then inserts two bone needles from the vertebral epiphysis to the vertebral body and administers polymethylmethacrylate (PMMA). This agent resembles cement and hardens quickly, thus stabilising the bone. It has the effect of immobilising the elements moving against each other, which can cause pain. Vertebroplasty of the spine is performed under fluoroscopy guidance and using needles with a diameter of 1-2 mm. The procedure usually takes about 30 minutes and does not require suturing of the wound – a dressing is sufficient.

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Vertebroplasty

What do you need to know before vertebroplasty?

First and foremost, it is important to be aware of the contraindications to its performance. This method of helping to treat spinal pain cannot be used if there is a blood clotting disorder. The procedure is also not performed in patients whose vertebral body is severely collapsed, as this prevents the procedure from being performed safely. Before vertebroplasty of the spine, a consultation with a neurosurgeon is essential. At such a visit, you need to have a current CT or MRI scan. Tests ordered by the doctor are also necessary. In addition, there is another consultation on the day of admission to the hospital ward – an anaesthetic consultation. Usually, patients can go home after the procedure on the same day, and there is no need for a longer stay in the facility.

Management after vertebroplasty

Discomfort may occur at the spinal puncture sites. To help alleviate it, it is a good idea to apply ice packs and reach for painkillers if necessary. For at least six weeks after vertebroplasty, you should limit your physical activity and avoid lifting heavy objects. This will enable the pressure on the fractured vertebra to be relieved and heal properly. It is also important to remember that you should not drive a car immediately after vertebroplasty. Often, rehabilitation under the guidance of a physiotherapist is also necessary, which can help you return to full fitness.

This usually involves exercises to stabilise the spine.

If the patient’s pain and other complaints were caused by a course of osteoporosis, additional therapy may be necessary in this area. This is usually based on taking medication to increase bone mineral density.

Minimally invasive treatment method – vertebroplasty

This procedure is commonly referred to as spinal cementation. Because it is performed using fluoroscopy, it is possible to monitor every movement on an ongoing basis and stop at the level of the relevant vertebra that requires treatment. Vertebroplasty of the spine is one of the frequently used methods to help treat pain, as it is minimally invasive and does not require prolonged hospitalisation.

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