Vertebroplasty of the spine is surgery, which is aimed at strengthening the vertebral body. Most often it is performed when the injuries or degenerative diseases of the spine, when there is a compression fracture or high risk to obtain it.
The procedure is performed using a specially developed substance, which is called bone cement.
In some cases the procedure is performed in the presence of vertebra vertebral hemangiomas, which can have all the signs of aggressiveness. To prove themselves they begin with such signs as pain and discomfort in the back, which occur with movements. Therefore, the main indication is severe pain that can last for several hours.
Also procedure is necessary and in that case, if there is a great risk of compression fracture. When using bone cement, the pain is almost completely restored all functions of the spine and spinal cord, and the risk of fracture is minimized.
Other indications for surgery include:
- Benign and malignant tumors of the spine.
- Metastases in the region of the vertebrae.
- Pain in osteoporosis.
- Fracture of vertebral bodies in osteoporosis, which is not amenable to medical treatment.
- Severe pain caused by osteonecrosis of a vertebral body, disease of Kümmel.
The procedure is not done healthy young people who received a particular spinal injury during a car accident or other accident. In this case, select another method of surgical intervention.
Nowadays there are relative and absolute contraindications for this procedure.
To absolute are:
- No symptoms of fracture, which occurred on the background of osteoporosis.
- Pain syndrome which can be cured with medication on a background of osteoporosis.
- The presence of local or General infection.
- Spinal stenosis bone tomcom.
- Compression of the spinal canal bone tomcom.
- Allergy to components bone cement.
Also operation can’t be done in the prevention of compression fractures due to osteoporosis.
Relative contraindications include radiculopathy that are not associated with compression fracture, displacement of the bone fragment without the development of symptom and lack of symptoms with the spread of the tumor into the epidural space.
The methodology of the
After adequate anesthesia, and most often it is local anesthesia performed with 2% lidocaine, done a few cuts on the skin of the back in the region of the affected vertebra.
After the cannula reaches the vertebral body, if necessary, performs a collection of material for histological examination. All this is done under careful fluoroscopic control. Then prepares a special mixture is injected into the cavity of the vertebra. This is done with a syringe of a high pressure.
To achieve a positive result, in the region of the thoracic vertebrae, it is sufficient for 2.5 – 3 ml of cement and 3 to 5 ml for lumbar vertebrae. After each 0, 5 – 1 ml of the material necessarily is x-rayed. If on the radiograph there are signs of leakage of material from cavity of the vertebra, the procedure is stopped.
After vertebroplasty on the back superimposed aseptic bandage.
- High efficiency.
- Low invasiveness.
- A small number of complications.
- Local anesthesia.
- Active movement immediately after surgery.
- Shortening of hospital stay (days).
There is often such complication, as allergic to the anesthetic. If you know that in the past there were such cases, lidocaine can be replaced by other means.
The second complication is getting into the surgical wound infections today, thanks to modern rules of asepsis and antisepsis, is very rare.
The third complication is the lack of effect. While the pain may not pass for a long time. If so, the patient requires further evaluation.
Leakage of the bone cement is possible when the operation is performed without a thorough radiographic control. This problem is rare and is corrected with additional surgery.