Surgical Procedures: Vertebroplasty

What is a compression fracture?

A compression fracture happens when there are small breaks or cracks in the vertebrae. The vertebrae are the bones that are stacked on top of one another to make up the spine. Compression fractures can lead to collapse or compression (pressing down) of the bone. It can cause you to be shorter, can cause pieces of bone to press on your spine and nerves, and lessen the amount of blood that gets to your spinal cord. Most often, cord compression leads to changes in how your body works and pain that can be hard to manage.

Compression fractures may be caused by cancer that starts in the bone or cancer that has metastasized (spread) to your bone, including breast, prostate, lung, and other cancers. It may also happen in non-cancerous, or benign conditions like osteoporosis, benign tumors, and osteonecrosis.

What is vertebroplasty and how is it done?

A vertebroplasty is a surgical procedure that fixes compression fractures in your vertebrae. A vertebroplasty will not treat your cancer, but it can help manage symptoms like pain.

A vertebroplasty is often done by a neurosurgeon, orthopedic surgeon, or interventional neuro-radiologist. Your provider will give you anesthesia (medication to help you sleep through the surgery, to not remember it, and to help with pain). Your provider will use a needle guided by X-ray to see the fracture. A material called polymethylmethacrylate, a bone cement, will be injected into the area where the fracture is found. At times, a kyphoplasty will be done. This is when a balloon is inflated to help bring the damaged vertebra back to its normal height, before putting in the cement. After the cement is put in, you may need to lie still and on your back.

What are the risks of vertebroplasty?

As with any surgical procedure, there are risks and possible side effects. These can be:

• Bleeding.
• Fever.
• Infection.
• Blood clots.
• Reaction to anesthesia (Reactions can include wheezing, rash, swelling, and low blood pressure).
• Spinal cord compression.
• Rib or other bone fractures.
• Leaking of bone cement which can lead to pain and the need for more treatment.
• Nerve damage which may lead to issues such as numbness or paralysis.
• Nerve root compression (when the nerve is being pressed on).

What is recovery like?

Recovery from vertebroplasty depends on the extent of the procedure. At times, a hospital stay is needed.

You will be told how to care for your surgical incisions and will be given any other instructions before leaving the hospital.

Your medical team will talk with you about the medications you will be taking, such as those for pain, blood clot, infection, and constipation prevention and/or other conditions.

Your provider will tell you what you should and should not do when you go home. This will often include:

• Taking pain medication as directed.
• Avoiding constipation caused by narcotic pain medications by increasing water and fiber intake and taking laxatives as directed.
• Slowly increasing activity after 24 hours or as directed.
• Following your care team’s recommendations on stretching, conditioning and strengthening exercises, as well as instructions on proper body mechanics.
• Keeping your surgical incision clean and dry. Your team will tell you how to care for your incision.  
• Avoid tub bathing until advised by your healthcare team; showering is recommended with gentle patting of the surgical incision when drying.

What will I need at home?

• Thermometer to check for fever which can be a sign of infection.
• Supplies to care for your incision.

When should I call my provider?

• Fever. Ask your provider at what temperature you should call them.
• Trouble walking.
• Trouble with holding your bowels or bladder.
• Signs of infection, which include redness, bleeding, odor, or drainage at the incision.
• Any other questions or concerns.

How can I care for myself?

You may need a family member or friend to help you with your daily tasks until you are feeling better. It may take some time before your team tells you that it is ok to go back to your normal activity.

Be sure to take your prescribed medications as directed to prevent pain, infection and/or constipation. Call your team with any new or worsening symptoms.

There are ways to manage constipation after your surgery. You can change your diet, drink more fluids, and take over-the-counter medications. Talk with your care team before taking any medications for constipation.

Taking deep breaths and resting can help manage pain, keep your lungs healthy after anesthesia, and promote good drainage of lymphatic fluid. Try to do deep breathing and relaxation exercises a few times a day in the first week, or when you notice you are extra tense.

• Example of a relaxation exercise: While sitting, close your eyes and take 5-10 slow deep breaths. Relax your muscles. Slowly roll your head and shoulders.

This article contains general information. Please be sure to talk to your care team about your specific plan and recovery.