Vertebroplasty And Kyphoplasty For Osteoporotic Spine Fracture And Spine Metastasis

By Author: Dr. Pankaj N Surange
Total Articles: 10
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Advanced age, asthma, diabetes, emphysema, menopause, chronic steroid use and rheumatoid arthritis are all risk factors for osteoporosis. The resultant weakening of bones can lead to compression fractures of the spine causing severe pain, deformity, loss of height, immobilization, and in some cases, failure to thrive.
Historically, vertebral compression fractures have been treated either with conservative methods of cast or brace immobilization with long term bed resting or with major surgery. This surgery requires a long incision, screws and rods for fixation and is done under general Anaesthesia. These treatments are limited by long recovery times and disruption of daily life.
Now, these painful spine fractures can be treated with a Minimally Invasive, Non Surgical procedure known as VERTEBROPLASTY, an innovative alternative to traditional treatments which stabilizes fractures of the spine safely and effectively, often providing immediate pain relief.

Q. Do we have any non-surgical procedure to fix spine fracture?

Vertebroplasty or targeted cementoplasty is one of the most advanced procedure ...
... for immediate and significant pain relief in patients with spine fracture or compression fracture due to osteoporosis. Osteoporosis is a condition where the bones becomes porous and fragile and leads to fracture with even minor trauma or jerk.

Q. How complicated is this vertebroplasty procedure for compression fracture of spine?

The procedure is very safe in experienced hands. There are costly options available but they have not proved to be more safer than vertebroplasty.
This procedure is done in Local anaesthesia, so we can even avoid the effects of general anaesthesia and patient can be discharged same day.
IPSC India is pioneer in performing this procedure.

Q. Is vertebroplasty a major surgery?
The goal of a vertebroplasty procedure is to stabilize the vertebral compression fracture to stop its painful movements. Vertebroplasty is considered a minimally invasive surgery because it is done through a small puncture in the skin instead of an open incision.

Q. Which procedure is better for spine fracture, Vertebroplasty or kyphoplasty.
Vertebroplasty and Kyphoplasty, both the procedures are done to fix the compression fracture of spine vertebrae. In Kyphoplasty, we use balloon to create some space inside the vertebrae and then fill that space with cement. But this makes kyphoplasty a difficult procedure as compared to Vertebroplasty and requires general anesthesia. Most of the recent studies have shown that there is no difference in outcome between the two procedures. Cost of the procedure is also less as compared to Kyphoplasty which is done under general anesthesia and may require hospital admission.

Q. What are the advantages compared to Surgical Fixation?

Vertebroplasty has several advantages:

Do not require general anaesthesia.
No need to open spine.
No need to put rods and screws.
No need of prolonged hospitalization.
All these reduces the risk of complications.

Q. How long does it take to recover from vertebroplasty?

Most people are able to walk after the procedure, but you may need to restrict yourself to home for 24 hours afterward to rest. Then you can slowly resume normal activity. Some patients, but not all, feel pain relief soon after vertebroplasty. These patients report that their pain is gone or is much better within 48 hours.
At times, due to involvement of other nearby structures, pain relief is not complete after the procedures. In such cases, your pain specialist may advise another procedure like facet joint block or facet denervation, or myofascial trigger point injection.

Q. Can we use vertebroplasty for old age and osteoporotic spine?

Yes! percutaneous vertebroplasty can be performed in spinal vertebrae that are not suitable for surgical fixation, for instance because of osteoporosis or because general anaesthesia may not be advised in patients who are very sick.
This procedure can also be performed in spine fractures due to spinal metastasis. Some cancers at some stages of cancer, spread to other areas like spine. These spinal pathologies are very painful and at times lead to fracture of spine.

Q. How this procedure is performed?
The beauty of this procedure is its simplicity. “A small needle is advanced into the fracture using only local anaesthetic followed by the placement of bone cement into the fractured area. The cement hardens in about 10-15 minutes and remarkably the pain is gone.”

“After performing good number of vertebroplasties, I can confirm that this is one of the most significant procedures for the treatment for vertebral compression fractures,”

Q. How long does bone cement take to set?
The calcium phosphate cement flows into the spongy inside portion of the bone, filling in microfractures and other damaged areas, and it hardens in about 10 minutes' time.

Dr (Maj) Pankaj N Surange
Interventional Spine and Pain Specialist
Spine Endoscopist and Vertebral Augmentation Specialist
Director, IPSC India, New Delhi
Director, IPSC India training institute.
Hon. Secretary, Indian society for study of pain