Vertebral augmentations are a category of surgical procedures that treat vertebral compression fractures. During these minimally invasive surgeries, a healthcare professional injects bone cement into the vertebral column to create an internal cast that relieves pain and stabilizes the spine. These procedures can restore lost height by introducing artificial vertebrae or expanding the spine using a special balloon. The type of vertebral augmentation your physician suggests depends on the cause of your vertebral compression fracture and what lasting symptoms it caused.
The types of vertebral augmentations are:
Vertebroplasty: A healthcare professional injects bone cement directly into the fractured vertebral body.
Balloon kyphoplasty: A physician injects a special balloon into the spine before inflating it to restore lost height in the spinal column. Once the vertebra returns to its original height, the physician injects thick bone cement into the fractured vertebral body.
Radiofrequency-targeted vertebral augmentation: This relatively new surgical option treats those vertebral compression fractures caused by metastatic spinal tumors. It uses radiofrequency energy to destroy tumor cells before a physician creates a cavity in the fractured vertebral bone. The physician will then slowly fill the cavity with bone cement. This slower cement injection reduces the risk of potential leakage of bone cement and can penetrate more minor fractures in the spine that other bone cement cannot.
Research on new vertebral augmentation procedures is ongoing.
Vertebral compression fracture
Reduces pain caused by compression fractures
Minimally invasive procedure
Provides vertebral stabilization
Lower risk procedure than traditional back surgery
Short recovery period
Before your procedure, your doctor may ask you to stop taking non-steroidal anti-inflammatory drugs (NSAIDs), immunosuppressant medication, and blood thinners to reduce your risk of serious complications or infections. If you are pregnant or suspect you are pregnant, talk to your doctor about alternative treatment options. Your healthcare professional may ask you not to eat or drink several hours before the procedure. This procedure cannot be performed if the patient has an active infection or symptoms of a cold, flu, or similar malady. If you experience these symptoms on the day of the procedure, you will need to reschedule your injections.
During the procedure, you will lie on your stomach on an x-ray table before the healthcare professional performing your vertebral augmentation administers a general anesthetic. They will sanitize the area of skin into which they will be injecting. Using x-ray guidance, the physician will insert a needle into your spinal cord.
During vertebroplasty, the physician will then inject bone cement into the area. During kyphoplasty, the physician will inject the special balloon and slowly inflate it. Once the vertebrae return to their original height, the physician will slowly pour bone cement into the spinal cavity.
During radiofrequency-targeted vertebral augmentation, your physician will enter the spine first to create a bone-sparing, site-specific channel for the bone cement. A radiofrequency generator activates the bone cement as your physician slowly injects the cement into the cavity.
The procedure lasts less than sixty minutes, and most patients return home the same day as their vertebral augmentation. You will remain in an observation room while the anesthesia wears off to ensure no immediate complications or allergic reactions occur.
You cannot drive after your surgery, nor can you for several days to weeks after it. You will need someone else to take you home. Your medical professional will provide you with specific instructions on when you can return to driving and other activities. You should avoid strenuous exertion for at least six weeks after your kyphoplasty. You may feel soreness or pain at the incision site, but this will dissipate over the next two to three days. Do not consume any alcohol after your surgery, as this thins your blood and increases the risk of bleeding. Alcohol may increase the likelihood of overdosing on pain medicine.
You may feel pain relief immediately after the surgery, but some patients do not report a decrease in pain for several days. The sooner this procedure is performed after a vertebral compression fracture occurs, the more effective it will be in providing long-term pain relief.
Vertebral augmentation procedures are generally safe, but there remains a low possibility of complications such as:
Infection, bleeding, or bruising at incision site
Accidental blockage of vein in lower back
Cement leakages into soft tissue around vertebrae
Inflamed spinal nerve or nerve damage
Medical errors resulting in fractured spine or ribs
Spinal cord direct lesion
Radiofrequency-targeted vertebral augmentation decreases the risk of extravasation, which occurs when blood or another liquid in the body leaks into the tissues surrounding it.