Vertebral augmentation is a category of surgical procedures used to stabilize a fractured vertebra to reduce the patient’s pain. These procedures are called vertebroplasty, kyphoplasty, or radiofrequency vertebral augmentation. Those who undergo a type of vertebral augmentation have usually suffered a fracture in a spinal vertebra. This type of fracture is called a compression fracture, usually caused by relatively minor trauma in patients with osteoporosis (a disease that weakens the spinal vertebrae, making it more prone to fractures). Vertebrae fractures can also be caused by spinal infections, tumors, or significant spinal trauma. A vertebral compression fracture is the result of the vertebra being unable to fully support its load, leading to it collapsing under the weight and creating cracks in the bone.
All vertebral augmentation procedures are minimally invasive surgeries that allow patients to go home the same day as the procedure. Sometimes the patient may stay overnight, but these procedures help patients find pain relief without spending too long in the hospital.
A vertebroplasty is a procedure where bone cement is injected directly into the fractured vertebral body to create an internal cast that stabilizes the fractured bone. Performing vertebroplasty involves carefully guiding a needle through a small puncture in the back and into the damaged vertebra. Once the needle is positioned, bone cement is injected into the tiny cracks. The bone cement fills the cracks and helps the bone solidify, eliminating pain by stabilizing the vertebra and preventing further collapse.
Vertebroplasty is considered to treat a vertebrae compression fracture when:
After the procedure, bedrest and taking it slow at home for the first 24 hours is usually recommended. Activity may gradually increase, and most regular medication can resume. Patients may experience soreness for a few days at the puncture site. This soreness can be treated with an ice pack. Most patients experience pain relief within 24 to 48 hours after the procedure. It’s advised to avoid strenuous physical activities for at least the first six weeks.
Kyphoplasty is a procedure that creates an internal cast inside of the fractured bone to stabilize the vertebrae. Furthermore, the procedure aims to reduce the deformity of the bone. In some cases, the compression fracture can cause kyphosis, which is the curving of the spine. Kyphoplasty addresses the deformity and restores the vertebrae’s height.
Kyphoplasty begins with a small incision made in the back through which the surgeon places a narrow tube. The tube creates a path through the back into the fractured area. The surgeon then inserts a special balloon through the tube and into the vertebrae and carefully inflates the balloon. As the balloon inflates, it elevates the fracture, returning the pieces to their normal position. It also compacts the inner bone to create a cavity inside the vertebrae. The balloon is removed, and specially designed instruments are used to fill the cavity with bone cement. After the bone cement is injected, the material hardens quickly, stabilizing the bone.
After a kyphoplasty, some patients experience immediate pain relief, while others see pain reduction after two days. At home, patients may return to their daily activities, though strenuous exertion should be avoided for a minimum of six weeks.
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In addition to kyphoplasty and vertebroplasty, other vertebral augmentation procedures have been recently introduced. For instance, radiofrequency-targeted vertebral augmentation consists of creating a cavity in the fractured vertebral bone but does not use a balloon as done in kyphoplasty.
The goal of radiofrequency-targeted vertebral augmentation is to fill the cavity with controlled delivery of bone cement slowly. The theory is that this method allows the bone cement to penetrate the small cracks and avoid potential leakage of the bone cement outside the fractured bone.
While both of these procedures are minimally invasive, they are not without significant risks. Like most medical procedures, the decision to undergo these procedures is made on a case-to-case basis and should not be taken lightly. Potential vertebral augmentation risks include:
Before considering any vertebral augmentation procedure, it’s important to consult a spinal specialist who can best advise the course of treatment for you.
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