- PVP Definition
- Kyphosis and Fractures
- Risks and Complications
What is percutaneous vertebroplasty?
Percutaneous vertebroplasty (PVP) is a procedure used to treat and stabilize vertebral (spinal) fractures. The process involves using a type of imaging called fluoroscopy, which provides X-rays in real time, to enable a doctor to inject a concrete-like fast-setting polymer into the damaged vertebrae.
A procedure called kyphoplasty often accompanies vertebroplasty. Kyphoplasty is the insertion and inflation of a balloon in the vertebrae before the cement delivery. This helps to repair loss of height in fractured vertebrae and restore alignment.
The doctor may use a SpineJack kyphoplasty system, which uses titanium implants in the bone that work together in the bone with the cement-like polymer to create a more stable outcome, reduce post-procedure pain, and better restore vertebral body height.
What is percutaneous vertebroplasty used for?
Percutaneous vertebroplasty is used to:
- Treat pain in vertebral (spinal) compression fractures
- Treat collapsed vertebrae from osteoporosis
- Treat spinal damage due to certain cancers and spinal tumors
- Stabilize weakened vertebrae prior to surgery
- Help repair alignment of vertebrae due to kyphosis
- Pain from vertebral hemangioma
How do doctors perform percutaneous vertebroplasty?
Before the vertebroplasty is performed, the doctor will formulate a plan to best treat the damaged vertebrae. This may include:
- Medical history and physical exam
- CT scans
- MRI of the spine
- Blood tests
- Complete blood count (CBC)
- Chemistry panel
- Coagulation panel (PT/PTT)
The actual vertebroplasty procedure may last between 30 minutes to two hours.
- Patient is placed in the prone position (face down)
- The area of the back around the damaged vertebrae is cleansed thoroughly with antiseptics to prevent infection
- Anesthesia is administered for conscious sedation
- Local anesthesia (such as lidocaine with epinephrine) is placed in the back at the level of the damaged vertebrae using a needle
- X-rays are performed using fluoroscopy to ensure proper localization of the damaged vertebrae and to guide placement of the cement compound
After the procedure
- Patients are put on bed rest for up to 2 hours
- Pain medications may be given
- Muscle relaxants may be given for muscle spasms
- Patients receive detailed follow-up instructions
- Patients are usually discharged the same day with a family member or friend who can help them after the procedure.
What are Risks and Complications of Percutaneous Vertebroplasty?
Complications from vertebroplasty are usually minimal and only occur in 1% to 10% of cases.
Possible complications may include:
- Infection in the skin or vertebrae
- Worsening of spinal fracture, especially when the original fracture is due to cancer
- Damage to spinal cord or adjacent nerves
- Allergic reaction to anesthetic or cement-like compound
- Collapsed lung
- Cement migration – cement compound leaks into surrounding tissues or bloodstream
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