Treatment for Spinal Compression Fractures

08-05-2021
Prelom kičmenog pršljena

Vertebroplasty is used to treat vertebral fractures by restoring the strength and height of the broken
bone.
It is usually performed on patients with severe pain that prevents them from functioning normally if the
pain lasts longer than 2 months. The goal of the vertebroplasty procedure is to stabilize the fracture of
the spine in order to stop its painful movements.
Vertebroplasty is considered a minimally invasive surgical procedure because it is performed through a
small puncture in the skin instead of an open incision. A typical vertebroplasty procedure usually takes
about 1 hour.

When Vertebroplasty is recommended

Vertebroplasty is indicated for the treatment of symptoms and complications of compression fractures
of the spine. The most common indication for vertebroplasty is the treatment of painful acute and
subacute vertebral fractures in patients who do not respond to appropriate medical therapy in a period
of 4-6 weeks.
Non-response to medical therapy is defined as minimal or no pain relief with prescribed analgesics or
inadequate pain relief in patients who are unable to tolerate narcotics due to side effects such as
sedation, confusion and constipation.

Causes of vertebral fractures

The causes of fractures are osteoporosis, which is the most common cause, bone metastases, or spinal
injuries, among other causes.
To assess the patient's suitability for the procedure, they undergo a clinical evaluation and physical
examination, followed by tests such as X-rays of the spine and various scanning techniques such as MRI,
CT scan of the spine. They can help localize fracture sites, as well as distinguish old fractures from new
ones.

Spinal vertebral surgery procedure

Although there may be variations in the way vertebroplasty is performed, the procedure is usually done
as follows:

  1. The patient goes to the operating room and lies face down on the table where the procedure will be
    performed.
  2. Local anesthesia and light sedation are used. The pain should not be felt in the area where the
    procedure takes place, but the patient usually stays awake and reacts.
  3. Using fluoroscopy, which displays X-ray images on a real-time video monitor, a bone biopsy needle is
    inserted into the broken vertebra through a small puncture in the skin.
  4. Special bone cement, injected under pressure directly into the broken vertebra. Bone cement fills
    cracks in the bones to create a type of internal plaster to stabilize the spine.
  5. The needle is removed and the cement hardens quickly (in about 10 minutes), thickening the
    fragments of the broken vertebra and stabilizing the bone.
    At the end of the observation period after the procedure, the patient can leave the medical institution
    and go home on the same day.
    Postoperative course
    Activity levels may increase gradually. Pain may appear at the site of the sting for several days, which can
    be relieved with an ice pack. Most patients experience pain relief within 24 to 48 hours after surgery.

Returning to strenuous physical activities, such as participating in sports or lifting heavy loads, is not
recommended for up to 6 weeks.
Vertebroplasty is considered a relatively safe procedure for reducing the pain caused by a vertebral
fracture, but it is still an operation and has certain risks.
All surgeries performed with some type of medication involve some serious risks, including infection,
allergic reaction, and excessive bleeding.
Possible complications after the operation

Other potential complications of vertebroplasty include:

  1.  Cement leaks – This problem can occur when bone cement leaks out of the intended cracks in the
    spine. Fortunately, there are rarely complications associated with leaking bone cement outside the
    fracture, especially if it is a small amount.
  2. Paralysis – Vertebroplasty is performed near the spinal cord and other important nerves, so that a
    mistake in the placement of the needle can potentially result in damage that causes weakness and / or
    paralysis of one or more limbs.
  3. Failure to reduce pain – Sometimes vertebroplasty does not improve symptoms, even if there were no
    mistakes or complications during the procedure.
    Atlas Klinka is a leader in spinal column operations. A team of highly trained doctors can compete with
    the world's largest spinal surgery centers.