Summary

Quality of Life Improvement

A Vertebral fracture may cause poor quality of life in elder women.

Percutaneous Vertebroplasty  in many cases could be the right therapy for Back-pain

Indications to Vertebroplasty

Severe painful Osteoporosis 

Painful vertebral tumors (metastases or myeloma) with high risk of fracture 

Symptomatic vertebral angioma 


ContraIndications to Vertebroplasty

Absolute

Asymptomatic stable fracture

Clinically effective medical therapy

Osteomyelitis of target vertebra

Uncorrected coagulation disorders

Acute traumatic fracture of non-osteoporotic vertebra

Prophylaxis with no evidence of acute fracture

Allergy to any required component

Local or systemic infection 

Relative

Radicular pain or radiculopathy caused by a compressive syndrome unrelated to vertebral body collapse 

Retropulsed fragment with > 20% spinal canal compromise

Tumor extension into epidural space

Stable fracture without pain older than one year


PERCUTANEOUS VERTEBROPLASTY:  What is it?

Vertebroplasty was developed in France  by Dr. Deramond and his colleagues in 1984. This innovative procedure helps alleviate pain caused by vertebral compression fractures. Vertebroplasty is minimally-invasive, outpatient procedure used to treat the pain associated with vertebral compression fractures caused by osteoporosis and tumoral lesions (metastases, myeloma, haemangioma, etc.). Individual vertebra weakened by disease can collapse suddenly under the force of normal daily activity; the resulting pain can be debilitating, causing limited mobility and other significant reductions in quality of life. Vertebral compression fractures used to be treated only with pain medications, bed rest and external bracing. However, these conservative measures are now considered the first line of treatment. If severe pain persists, patients can be referred to a specially-trained Physician for evaluation for vertebroplasty.

During vertebroplasty, the collapsed vertebra is stabilized with specially formulated acrylic bone cement (PMMA - polymethylmethacrylate); in addition to providing pain relief, vertebroplasty can prevent further collapse of the vertebra, height loss and spine curvature.

This procedure is usually performed in local anesthesia placing a special designed needle in the vertebral body. A precise needle positioning is obtained under CT and/or digital Fluoroscopy guidance.

Injection of few ml of cement (from 2 to 4 ml) achieves a new solidity either of the collapsed osteoporotic vertebra or of the soft tumoral tissue with pain decreasing.

For most patients, vertebroplasty provides immediate and lasting relief of the pain related to vertebral compression fractures. Many patients return to their normal activities within only a few days of having the procedure, and most of them report continued relief from pain months and years later.