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
    • Women have a 16% lifetime risk of getting a vertebral compression fracture, due to the higher risk of osteoporosis in women (men’s lifetime risk is 5%)
  • 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: 

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. 

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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
  • Paralysis
  • Allergic reaction to anesthetic or cement-like compound
  • Bleeding
  • Collapsed lung
  • Cement migration – cement compound leaks into surrounding tissues or bloodstream

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Medically Reviewed on 4/24/2020
References
Medscape Medical Reference
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