However, some patients may require general anesthesia. Your doctor may provide medications to help prevent nausea and pain and antibiotics to help prevent infection.
The area through which the hollow needle, or trocar, will be inserted will be shaved, sterilized with a cleaning solution and covered with a surgical drape. A local anesthetic is then injected into the skin and deep tissues, near the fracture. Using x-ray guidance, the trocar is passed through the spinal muscles until its tip is precisely positioned within the fractured vertebra.
In vertebroplasty, the orthopedic cement is then injected. Medical-grade cement hardens quickly, typically within 20 minutes. The trocar is removed after the cement is injected. In kyphoplasty, the balloon tamp is first inserted through the needle and the balloon is inflated, to create a hole or cavity. The balloon is then removed and the bone cement is injected into the cavity created by the balloon.
The doctor applies pressure to prevent any bleeding and covers the opening in the skin with a bandage. No sutures are necessary. This procedure is usually completed within one hour. It may take longer if more than one vertebral body level is being treated. The doctor or nurse will attach devices to your body to monitor your heart rate and blood pressure. You will feel a slight pinch when the nurse inserts the needle into your vein for the IV line and when they inject the local anesthetic.
Most of the sensation is at the skin incision site. The doctor will numb this area using local anesthetic. You may feel pressure when the doctor inserts the catheter into the vein or artery. However, you will not feel serious discomfort. If the procedure uses sedation, you will feel relaxed, sleepy, and comfortable. You may or may not remain awake, depending on how deeply you are sedated. During the procedure you will be asked questions related to your comfort.
It is important for you to be able to tell your doctor whether you are feeling any pain. The longest part of vertebroplasty and kyphoplasty procedures involves setting up the equipment and making sure the needle is perfectly positioned in the collapsed vertebral body.
You may not drive after the procedure, but you may be driven home if you live close by. Otherwise, an overnight stay at a nearby hotel is advised. You will be advised to increase your activity gradually and resume all your regular medications. At home, patients may return to their normal daily activities, although strenuous exertion, such as heavy lifting, should be avoided for at least six weeks. If you take blood thinners, check with your doctor about restarting this medication the day after your procedure.
Pain relief is immediate for some patients. In others, pain is eliminated or reduced within two days. Pain resulting from the procedure will typically diminish within two to three days. For two or three days afterward, you may feel a bit sore at the point of the needle insertion.
You can use an icepack to relieve any discomfort but be sure to protect your skin from the ice with a cloth and ice the area for only 15 minutes per hour. Your bandage should remain in place for 48 hours. Do not immerse the bandage in water for 48 hours. This is to prevent infection. Taking showers is allowed. Approximately one hour after the procedure, you should be able to walk. The interventional radiologist is often able to advise you as to whether the procedure was a technical success at that point.
This visit may include a physical check-up, imaging exam s , and blood tests. During your follow-up visit, tell your doctor if you have noticed any side effects or changes. Please type your comment or suggestion into the text box below. Note: we are unable to answer specific questions or offer individual medical advice or opinions.
Please contact your physician with specific medical questions or for a referral to a radiologist or other physician. To locate a medical imaging or radiation oncology provider in your community, you can search the ACR-accredited facilities database. This website does not provide cost information. The costs for specific medical imaging tests, treatments and procedures may vary by geographic region.
Web page review process: This Web page is reviewed regularly by a physician with expertise in the medical area presented and is further reviewed by committees from the Radiological Society of North America RSNA and the American College of Radiology ACR , comprising physicians with expertise in several radiologic areas.
Outside links: For the convenience of our users, RadiologyInfo. Vertebroplasty and kyphoplasty are similar procedures. Both are performed through a hollow needle that is passed through the skin of your back into the fractured vertebra. In vertebroplasty, bone cement called polymethylmethacrylate is injected through the hollow needle into the fractured bone. In kyphoplasty, a balloon is first inserted and inflated to expand the compressed vertebra to its normal height before filling the space with bone cement.
The procedures are repeated for each affected vertebra. The cement-strengthened vertebra allows you to stand straight, reduces your pain, and prevents further fractures. Without treatment, the fractures will eventually heal, but in a collapsed position. The benefit of kyphoplasty is that your vertebra is returned to normal position before the bone hardens. Patients who've had kyphoplasty report significantly less pain after treatment [1].
Studies show that people who get one osteoporotic fracture are 5 times more likely to develop additional fractures. It is important that people seek treatment for osteoporosis early, before fractures occur. Vertebroplasty or kyphoplasty may be a treatment option if you have painful vertebral compression fractures from:. Vertebroplasty and kyphoplasty will not improve old and chronic fractures, nor will they reduce back pain associated with poor posture and stooping forward.
Traditional treatment used to involve waiting 4 to 6 weeks to see if patients improved on their own, but now it's believed that waiting allows the bone to harden, making vertebroplasty or kyphoplasty less effective. Many doctors are now suggesting vertebroplasty as soon as the first week after a fracture for some patients because the results are significantly better [2].
The surgeon will perform a complete medical history and physical exam. Diagnostic studies MRI , CT , bone scan may be included in your evaluation to make a diagnosis of vertebral compression fracture. Your surgeon will also determine if your spine is "stable" or "unstable" and will discuss with you all treatment options. Kyphoplasty can be performed by a neurosurgeon, orthopedic surgeon, or interventional neuroradiologist. Many spine surgeons have specialized training in minimally invasive spine surgery.
Ask your surgeon about his or her training and success rate with these procedures. Presurgical tests e. Consult your primary care physician about stopping certain medications and ensure you are cleared for surgery. Continue taking the medications your surgeon recommends. Stop taking all non-steroidal anti-inflammatory medicines ibuprofen, naproxen, etc.
Stop using nicotine and drinking alcohol 1 week before and 2 weeks after surgery to avoid bleeding and healing problems. It kills bacteria and reduces surgical site infections. Avoid getting CHG in eyes, ears, nose or genital areas. You may take permitted medicines with a small sip of water. Patients are admitted to the hospital the morning of the procedure.
To minimize pain and discomfort, you will be given either general anesthesia, which puts you to sleep, or conscious sedation. Under conscious sedation you are awake, but feel no pain and may have no memory of the procedure. Step 1: prepare the patient You will lie on the operative table and be given conscious sedation.
Once sedated, you will be positioned on your stomach with your chest and sides supported by pillows. Depending on the section of the spine cervical, thoracic, or lumbar where the compressed vertebra is located, your back or neck will be cleansed and prepped. Imaging tests such as an X-ray or MRI scan will help your surgeon see the area or areas that need repair. In preparation, an intravenous line IV will be placed in a vein in your arm to deliver anesthesia.
You may also receive pain and anti-nausea medications, as well as antibiotics to prevent infection. For these procedures, you need to lie down on your stomach. The area in which the needle will be inserted is shaved if necessary, and then cleaned and sterilized.
A local anesthetic may be injected in the same place. You may be encouraged to get up and walk within an hour of the procedure. Some soreness is to be expected. You may be able to go home later that day. However, you might need to stay in the hospital overnight for monitoring if:. Your doctor will advise you when you can resume normal activities and if you should take any bone-strengthening supplements or medications.
An ice pack can help relieve immediate soreness or pain, but you should be feeling better within 48 hours. All medical procedures have some level of risk. In some cases, nerve damage can lead to numbness, weakness, or tingling.
After kyphoplasty or vertebroplasty, about 10 percent of people end up with more compression fractures. There are many signs of osteoporosis, both large and small. Learn what they are so you can prevent or treat this condition. Bone fracture repair is a surgery to fix a broken bone using metal screws, pins, rods, or plates to hold the bone in place. There are several….
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