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YOU are here : Home > Spinecare Topics > Intervention - Spinal Disorders > Minimally Invasive Intervention for Spine Pain
Spinecare Topics
Intervention - Spinal Disorders
Minimally Invasive Intervention for Spine Pain
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Minimally Invasive Intervention for Spine Pain
Additional causes of vertebral compression fractures include primary destructive tumor or metastatic disease within the body of a vertebra. Advanced imaging and biopsy is often used to help differentiate vertebral compression fracture secondary to osteoporosis versus other problems such as cancer. Some osteoporotic fractures are associated with mild pain and may have relatively good infrastructure and stability. Patients who have severe disability or intractable pain should be treated immediately.
Procedure: Fluoroscopy is generally the preferred method of image guidance for performing percutaneous vertebroplasty. Computerized tomography can also be utilized. Sometimes a combination of CT and fluoroscopy is utilized. Prior to undergoing the procedure, specialized laboratory tests are usually performed. The tests usually include evaluation of blood clotting. A CBC is also performed to help evaluate whether there is a high white blood cell count that may be associated with an underlying infection or other medical condition. Usually intravenous antibiotics are routinely given to help reduce the risk for post-interventional infection. It is common to use both local anesthetics as well as conscious sedation to make the patient comfortable during percutaneous vertebroplasty.
The attending spine specialist will choose the type of cement to be used in the PV procedure. There are numerous routes for needle delivery of the cement into the vertebral body. The best and most efficient route will be chosen. Once the needle route is chosen a local anesthetic is administered. A small incision is made. Incremental needle placement is performed under imaging guidance. Advancing the needle into the vertebral body is generally very easy. It is easier when there is osteoporotic or thinned bone. At times a mallet may be used to advance the needle through dense bone. The tip of the needle should be placed into the center region of the vertebral body. At times more than one needle is utilized. The use of vein imaging may be used to help identify potential problems prior to injecting the cement. The cement is prepared after the needles are placed. An opacifying agent is often mixed with the cement to allow for better imaging of cement migration and placement. The cement is then introduced into the vertebral body. Continuous imaging is performed during the procedure to identify whether there is any cement leak, which would be an indication to stop the procedure.
The pain relief associated with percutaneous vertebroplasty is primarily related to the stabilization of the vertebra then to the absolute amount of cement utilized. It is felt that relatively small amounts of cement are required to help restore mechanical strength of the vertebral body.
Goals of The Procedure: The primary goals of the procedure are to provide stabilization to the vertebral body and thus stabilization to the spine segment. The secondary goal is to reduce deformity and pain associated with vertebral collapse.
Procedure: Fluoroscopy is generally the preferred method of image guidance for performing percutaneous vertebroplasty. Computerized tomography can also be utilized. Sometimes a combination of CT and fluoroscopy is utilized. Prior to undergoing the procedure, specialized laboratory tests are usually performed. The tests usually include evaluation of blood clotting. A CBC is also performed to help evaluate whether there is a high white blood cell count that may be associated with an underlying infection or other medical condition. Usually intravenous antibiotics are routinely given to help reduce the risk for post-interventional infection. It is common to use both local anesthetics as well as conscious sedation to make the patient comfortable during percutaneous vertebroplasty.
The attending spine specialist will choose the type of cement to be used in the PV procedure. There are numerous routes for needle delivery of the cement into the vertebral body. The best and most efficient route will be chosen. Once the needle route is chosen a local anesthetic is administered. A small incision is made. Incremental needle placement is performed under imaging guidance. Advancing the needle into the vertebral body is generally very easy. It is easier when there is osteoporotic or thinned bone. At times a mallet may be used to advance the needle through dense bone. The tip of the needle should be placed into the center region of the vertebral body. At times more than one needle is utilized. The use of vein imaging may be used to help identify potential problems prior to injecting the cement. The cement is prepared after the needles are placed. An opacifying agent is often mixed with the cement to allow for better imaging of cement migration and placement. The cement is then introduced into the vertebral body. Continuous imaging is performed during the procedure to identify whether there is any cement leak, which would be an indication to stop the procedure.
The pain relief associated with percutaneous vertebroplasty is primarily related to the stabilization of the vertebra then to the absolute amount of cement utilized. It is felt that relatively small amounts of cement are required to help restore mechanical strength of the vertebral body.
Goals of The Procedure: The primary goals of the procedure are to provide stabilization to the vertebral body and thus stabilization to the spine segment. The secondary goal is to reduce deformity and pain associated with vertebral collapse.
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