What is a vertebroplasty or Kyphoplasty and how is it performed?
A vertebroplasty is a minimally-invasive procedure used to strengthen broken vertebra caused mainly by osteoporosis and cancer. This procedure is most commonly used for patients who have not shown improvements with pain medication and braces. A cement mixture is injected into the broken vertebra, enabling the bone to become stronger. This procedure can increase a patient’s physical activity and prevent future vertebral fractures. Most patients feel pain relief immediately. The Kyphoplasty procedure involves the use of a balloon to restore the vertebral body height and shape and is followed by the injection of bone cement to strengthen it.
Vertebroplasty and Kyphoplasty are done in an interventional radiology suite, usually by an interventional radiologist or neuroradiologist. Prior to the procedure, local anesthetic will be used to numb the area where a small incision will be made near the spinal fracture. The patient typically receives deep sedation, however, on occasion patients may require general anesthesia to tolerate lying on the abdomen during the procedure. To confirm correct needle placement and prevent displacement of the acrylic, or bone cement, a small amount of contrast medium (barium) is mixed along with the cement. Complications include bleeding, embolus due to migration of the cement, nerve root irritation, pneumothorax, and infection.
After the procedure is completed, patients are instructed to lie flat for two hours while the cement hardens. After that, patients are slowly raised to a sitting position while they are assessed for pain, numbness of the lower extremities, and weakness. They are then allowed to walk with assistance then discharged home. Pain relief is often immediate, but localized tenderness at the injection site is common.
Before the Procedure:
Prior to scheduling the procedure, we will need to evaluate an MRI, bone scan, or CT scan of your spine showing the fracture and may ask you to come in for a consult with Dr. Bartynski or Rothfus to evaluate your pain. At that time you will be sent for an anesthesia consult and pre-procedure testing. Once scheduled for the procedure, you will be contacted by one of the spine nurses. You will be asked to provide information regarding you current problem, past medical history, and medications. She will provide you with detailed instructions on how to prepare for the upcoming procedure. You will be asked to hold any NSAIDS, Aspirin, or blood thinners such as Coumadin. Any insurance questions can be answered by your referring physician.
The Day of the Procedure:
Prior to arrival we ask that you refrain from eating or drinking after midnight the night before. Please bring your pain medications with you. We do not dispense or provide prescriptions for medications after the procedure. You will need someone to drive you home. Patients without a driver will be rescheduled for another day.
How soon can I return to my normal activities following vertebroplasty or Kyphoplasty?
Patients are instructed to resume activity slowly during the next few days and refrain from driving for 24 hours. They are also instructed to look for bleeding or signs of infection, such as redness, swelling, or drainage from the injection site, and to treat any post-procedure back pain as they had done so previously. Patients are then contacted at intervals of one-day, one-week, and one-month to assess progress.
Is Vertebroplasty or Kyphoplasty covered by insurance?
You should direct any insurance questions to your referring physician and/or insurance provider.