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YOU are here : Home > Spinecare Topics > Options for Spine Treatments > Advancements in Spine Care and Spine Surgery
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Options for Spine Treatments
Advancements in Spine Care and Spine Surgery
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Advancements in Spine Care and Spine Surgery
Prior to vertebroplasty, the therapeutic options for a vertebral body compression fracture was primarily limited to bed rest, pain management, anti-inflammatory approaches, activity modification, supportive bracing or invasive spine surgery. Vertebroplasty may prevent the need for using stabilizing instrumentation during surgery to support the spine.
Vertebroplasty is performed using state-of-the-art imaging (fluoroscopic) to guide the cannula to the center of the collapsed vertebra. A local anesthetic is used to numb the skin and muscle. After a successful anesthetic approach, a needle guided by imaging is positioned into the collapsed vertebral body. A contrast agent may be used to help confirm proper needle placement within the vertebral body. After proper needle placement a cement-like material is injected into the vertebral body. This material is an polymethylmethacrylate (PMMA) Bone Cement that hardens over 5-20 minutes. A CT scan is usually obtained after vertebroplasty to assess the distribution of cement within the vertebral body. Currently CT is more valuable than MRI for immediate assessment of this procedure.
Potential complications of Vertebroplasty include bleeding, infection, and increased pain. In rare cases the injected material can leak out of the vertebral body into surrounding tissues and veins. In some cases surgical intervention may be required to remove material that may have leaked form the site of injection.
Candidates for the procedure include individuals who have chronic back pain (at least 6 weeks) and limited mobility secondary to vertebral body fracture. Most individuals have limited mobility and subsequently cannot perform activities of daily living (ADLs), such as dressing, bathing and walking. Vertebroplasty is reserved for those individuals who have not responded favorably to a conservative course of care such as bed rest, back brace, and oral pain medications. Not everyone with a vertebral body collapse is a good candidate for vertebroplasty. Careful assessment is required to ensure that symptoms and limited mobility is directly related to vertebral fracture, rather than something else. Other fairly common causes for back pain include disc herniation, facet syndrome. Muscle strain, nerve injury and spinal segment instability.
Kyphoplasty
Kyphoplasty also referred to as balloon kyphoplasty, is a similar procedure to vertebroplasty except that a balloon catheter device is inserted into the region of vertebral collapse under fluoroscopy and inflated to create a cavity or void for the bone cement to fill. The cannula is inserted similar to vertebroplasty through a transpedicular entry to the vertebral body. The advantages of kyphoplasty over vertebroplasty include reduction of vertebral angulation and less chance of extravasation of bone cement or other complications. There have been close to 400,000 balloon kyphoplasty procedures since its release to the market in 2000. Balloon kyphoplasty is used with greater frequency over vertebroplasty because of reported benefits and reduced need for medication.
Vertebroplasty is performed using state-of-the-art imaging (fluoroscopic) to guide the cannula to the center of the collapsed vertebra. A local anesthetic is used to numb the skin and muscle. After a successful anesthetic approach, a needle guided by imaging is positioned into the collapsed vertebral body. A contrast agent may be used to help confirm proper needle placement within the vertebral body. After proper needle placement a cement-like material is injected into the vertebral body. This material is an polymethylmethacrylate (PMMA) Bone Cement that hardens over 5-20 minutes. A CT scan is usually obtained after vertebroplasty to assess the distribution of cement within the vertebral body. Currently CT is more valuable than MRI for immediate assessment of this procedure.
Potential complications of Vertebroplasty include bleeding, infection, and increased pain. In rare cases the injected material can leak out of the vertebral body into surrounding tissues and veins. In some cases surgical intervention may be required to remove material that may have leaked form the site of injection.
Candidates for the procedure include individuals who have chronic back pain (at least 6 weeks) and limited mobility secondary to vertebral body fracture. Most individuals have limited mobility and subsequently cannot perform activities of daily living (ADLs), such as dressing, bathing and walking. Vertebroplasty is reserved for those individuals who have not responded favorably to a conservative course of care such as bed rest, back brace, and oral pain medications. Not everyone with a vertebral body collapse is a good candidate for vertebroplasty. Careful assessment is required to ensure that symptoms and limited mobility is directly related to vertebral fracture, rather than something else. Other fairly common causes for back pain include disc herniation, facet syndrome. Muscle strain, nerve injury and spinal segment instability.
Kyphoplasty
Kyphoplasty also referred to as balloon kyphoplasty, is a similar procedure to vertebroplasty except that a balloon catheter device is inserted into the region of vertebral collapse under fluoroscopy and inflated to create a cavity or void for the bone cement to fill. The cannula is inserted similar to vertebroplasty through a transpedicular entry to the vertebral body. The advantages of kyphoplasty over vertebroplasty include reduction of vertebral angulation and less chance of extravasation of bone cement or other complications. There have been close to 400,000 balloon kyphoplasty procedures since its release to the market in 2000. Balloon kyphoplasty is used with greater frequency over vertebroplasty because of reported benefits and reduced need for medication.
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