Percutaneous Vertebroplasty

Percutaneous vertebroplasty (PVP) is a minimally invasive medical procedure used to stabilize and strengthen compressed or fractured vertebrae, typically in the spine.

Indications

• Osteoporotic vertebral compression fractures
• Traumatic vertebral compression fractures
• Vertebral tumors, such as metastatic cancer or multiple myeloma
• Vertebral hemangiomas (benign vascular tumors)

Procedure

The procedure involves the following steps:

1. The patient is given local anesthesia and, in some cases, conscious sedation to minimize discomfort.
2. A small incision is made in the skin, and a needle is inserted under fluoroscopic guidance (live X-ray imaging) into the fractured vertebra.
3. Bone cement, typically polymethylmethacrylate (PMMA), is injected through the needle into the vertebral body to stabilize and strengthen the bone.
4. The cement hardens quickly, usually within 10-15 minutes, providing immediate stability to the fractured vertebra.

Benefits

• Rapid pain relief: PVP can provide significant reduction in back pain and discomfort.
• Improved mobility: By stabilizing the spine, patients may experience improved mobility and ability to perform daily activities.
• Minimally invasive: The procedure is performed through a small incision, resulting in less tissue damage and trauma compared to open surgery.

Risks and Complications

• Bleeding or hematoma at the injection site
• Infection
• Nerve damage or irritation
• Leakage of bone cement into surrounding tissues or blood vessels
• Pulmonary embolism (rare)

Post-Procedure Care

After the procedure, patients are typically monitored for a few hours to ensure there are no complications. They may be advised to:

• Avoid heavy lifting or bending
• Rest and avoid strenuous activities for several days
• Take pain medication as directed by their doctor
• Follow up with their doctor for further evaluation and management

Outcomes

The success of PVP in relieving pain and improving mobility varies depending on the individual case. Studies have shown that:

• 70-90% of patients experience significant pain relief after PVP
• Improved mobility and functional ability are reported by many patients
• The procedure can be effective in reducing the need for pain medication and improving overall quality of life