Vertebroplasty is used to treat pain caused by osteoporotic compression fractures. After menopause, women are especially vulnerable to bone loss. More than one-fourth of women over age 65 will develop a vertebral fracture due to osteoporosis. Older people suffering from compression fractures tend to become less mobile, and decreased mobility accelerates bone loss. High doses of pain medication, especially narcotic drugs, further limit functional ability.
Vertebroplasty is often performed on patients too elderly or frail to tolerate open spinal surgery, or with bones too weak for surgical spinal repair. Patients with vertebral damage due to a malignant tumor may sometimes benefit from vertebroplasty. In rare cases, it can be used in younger patients whose osteoporosis is caused by long-term steroid treatment or a metabolic disorder.
Typically, vertebroplasty is recommended after simpler treatments, such as bedrest, a back brace or pain medication, have been ineffective, or once medications have begun to cause other problems, such as stomach ulcers.
This procedure was first done in 1984 by Jansen and Dion in the University of Virginia. During Vertebroplasty, a collapsed vertebra (usually a wedge-shaped vertebral collapse) is assessed and if it meets the criteria for vertebroplasty, it is then accessed via a trocar through which liquid acrylic cement (polymethylmethacrylate – PMMA) material is injected into the vertebral body space and allowed to expand and correct to a significant degree the vertebral collapse that has occurred in the patient. This usually tends to result in significant and often near dramatic improvement in the patient’s pain and symptoms that is not often relieved by other means. In addition spinal axial stabilization is achieved and function rapidly restored.
The actual technique in vertebroplasty requires fluoroscopic guidance and sometimes the use of a CT scan is added. Frequently, vertebroplasty technique can be used at the lumbar level or even the thoracic axial spine level with good results. In osteoporosis, vertebroplasty treatment is done in conjunction with medical treatment and the use of a post-procedure stabilizing corset.