Surgical Procedures: Vertebroplasty
What is a vertebroplasty and how is it performed?
A vertebroplasty is a surgical procedure that is done to repair compression fractures in the spinal vertebra, the bones which make up the spine.
A vertebroplasty may be recommended in some cases of cancers within the bone that have caused a compression fracture. These fractures may be caused by a cancer that starts in the bone or another type of cancer that has spread to the bone, including breast, prostate, lung and other cancers. It may also be recommended in non-cancerous, or benign conditions like osteoporosis, benign tumors, and osteonecrosis.
During this procedure, your surgeon (neurosurgeon, orthopedic surgeon, or interventional neuro-radiologist) will inject a material called polymethylmethacrylate, a bone cement, into the area where the fracture is located. At times, a kyphoplasty will be performed at the same time. This procedure inflates a balloon to restore the normal height of the damaged vertebra prior to instilling the cement.
What are the risks associated with vertebroplasty?
As with any surgical procedure, there are risks and possible side effects associated with undergoing a vertebroplasty. These can be:
- Blood clots
- Reaction to anesthesia. (Anesthesia is the medication you are given to help you sleep through the surgery, not remember it and to manage pain. 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 additional treatment.
- Nerve damage which may lead to issues such as numbness or paralysis.
- Nerve root compression.
What is recovery like?
Recovery from a vertebroplasty will depend on the extent of the procedure performed. At times, a hospital stay is required.
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 discuss with you 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:
- Take pain medication as directed.
- Avoid constipation caused by narcotic medications by increasing water and fiber intake and taking laxatives as directed.
- Gradually increase activity after 24 hours.
- Follow your healthcare team’s recommendations on stretching, conditioning and strengthening exercises, as well as instructions on proper body mechanics.
- Keep your surgical incision clean, dry and intact for 24 hours.
- 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 to call your provider?
- Fever. Ask your provider at what temperature you should call them.
- Trouble walking.
- Trouble with holding your bowels or bladder.
- Any other questions or concerns.
- Signs of infection, which include redness, bleeding, odor or drainage at the incision.
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.
Johns Hopkins Medicine. Vertebroplasty. Retrieved from http://www.hopkinsmedicine.org/healthlibrary/test_procedures/orthopaedic/vertebroplasty_135,37/
Mayfield Brain and Spine. Vertebroplasty & Kyphoplasty. Retrieved from http://www.mayfieldclinic.com/PE-Kyphoplasty.htm
Vertebroplasty and Kyphoplasty for Cancer Pain. Retrieved from http://www.iasp-pain.org/files/Content/ContentFolders/GlobalYearAgainstPain2/CancerPainFactSheets/Vertebroplasty_Final.pdf