Osteoporosis, the most common form of compression fractures, is the loss of bone mass. Osteoporosis is the most common cause of vertebral compression fractures in the United States. The National Osteoporosis Foundation (NOF) estimates that over 50 million Americans over the age of 50 currently have osteoporosis or low bone mass with serious risk of osteoporosis. A large portion of this population will suffer debilitating pain caused by vertebral compression fractures. It is most often found in women after menopause, and can also be caused by certain medications or diseases. Osteoporosis is the most common form of compression fractures. Nearly all vertebral fractures in otherwise healthy people are due to osteoporosis, and can occur from a minor impact, such as a bump or a fall, in those who suffer from this bone-weakening disease. People who have a spinal fracture often don’t realize that they may have osteoporosis, because the disease is asymptomatic until a fracture occurs. Many patients with compression fractures caused by Osteoporosis can be helped with this procedure.
Factors that increase the likelihood of developing osteoporosis include:
Bone tumors and metastatic bone disease also lead to vertebral compression fractures. Diseases such as multiple myeloma and hemangioma (types of tumors) place patients at great risk for these painful fractures. High doses of steroids for the control of auto-immune diseases such as lupus and rheumatoid arthritis, as well as asthma or chronic pulmonary disease can also increase the risk of reduced bone mass and resulting fractures.
Percutaneous vertebroplasty may be done either as an inpatient or outpatient procedure, depending upon the severity of the fracture and the health of the patient. After suitable sedation is given, a needle is placed into the affected vertebra and fills the damaged area with bone cement.
If you are on Coumadin, Heparin, Plavix or any other blood thinners (including Aspirin), or the diabetic medication Glucophage you must notify this office so the timing of these medications can be explained. You will either be at clinic facility or hospital for approximately 2-3 hours for your procedure. You will need to bring a driver with you.
During the Procedure
It is standard procedure to have an IV needle placed in your arm, and to be given a light sedative. After you are in position on the operating table, your back will be numbed with a local anesthetic. Under x-ray guidance, your physician will place an access needle into your vertebral body. You may experience mild discomfort during this part of the procedure. When the cement is injected you will have recreation of your regular back pain.
After the procedure
You must lay flat after the procedure. You will need to follow-up in the clinic after five to ten days.
Keep the area clean and dry to help prevent skin infection. Do not do any heavy lifting for 3 months (i.e. nothing heavier than a carton of milk). After that, you can gradually increase your lifting to normal. Walking is encouraged and you can bend within the restrictions of your brace.
You may experience some muscle discomfort where the needles were placed. This may be treated with a mild pain reliever such as Tylenol. Do not drive for the remainder of the day. Please have an adult drive you home or accompany you in a taxi or other public transportation. Depending on how you feel, you may resume normal activities and return to work the next day.
Benefits: Immediate Relief from Pain, Improved Quality of Life
Following vertebroplasty, most patients (>90%) find a marked improvement in their pain, improved mobility and other quality of life improvements. Within a few days, many patients are able to reduce their pain medications significantly and return to the normal daily activities that had been inhibited by their painful vertebral compression fractures. Most patients report sustained pain relief, even years later.
What are the risks of Vertebroplasty?
The risks are minimal and in fact, few complications have been reported involving less than five percent of cases. As with any procedure, there is a risk of significant complications. The most common side effects from the nerve root block can include (but are not limited to):