Thoracic Vertebroplasty
Disease Overview
Osteoporosis is a “silent” disease characterized by weakening of bones, making them more susceptible to fractures (vertebral compression fractures), typically in the hip and spine. Vertebral compression fractures can also occur with a metastatic tumor, multiple myeloma, and vertebral hemangioma.
Causes of Vertebral Compression Fractures
The elderly and especially post-menopausal women are at a greater risk of developing osteoporosis. The mid-to-lower back area of the spine is mainly involved in weight-bearing, making these regions of the spine more prone to collapse with bone weakness. This can lead to spinal (vertebral) compression fractures. Many of these vertebral compression fractures occur by minimal trauma or by no trauma at all - while performing simple activities such as bending and twisting.
Symptoms of Vertebral Compression Fractures
Symptoms of vertebral compression fractures range from severe pain in the back, arms and legs to no pain at all. You may think that the back pain you experience is just a part of aging, and let these vertebral compression fractures go undiagnosed. However, a single vertebral fracture significantly increases your risk of further fractures.
When multiple fractures occur, it causes the spine to become rounded and bent forward, resulting in loss of height and a hunchback appearance. This forward curvature of the spine negatively affects your quality of life and makes it more difficult to breathe, eat, walk and sleep.
What is Thoracic Vertebroplasty?
Thoracic vertebroplasty is a minimally invasive procedure performed to reduce or eliminate pain caused by vertebral compression fractures. It stabilizes the fracture and prevents further collapse of the vertebra, averting deformity.
Thoracic Vertebroplasty Procedure
The vertebroplasty procedure involves the injection of bone cement into the fractured vertebra under high pressure. The procedure is done under general or local anesthesia. You will be lying face down on the operating table. Your doctor will make a 1/2-inch incision in the skin over the fracture site. Under live X-ray guidance, a hollow needle called a trocar is introduced through the back and is positioned within the fractured vertebrae. Next, bone cement is injected into the area through the trocar under high pressure. After the vertebral body is filled completely with the bone cement, the needle is withdrawn before the cement hardens. X-rays or CT scans may be taken to confirm the effective spread of the bone cement into the fractured vertebra. The skin incision is closed using steri-strips.
Contraindications of Thoracic Vertebroplasty
Thoracic vertebroplasty cannot be performed under the following situations:
- A compression fracture is stable and does not cause any pain
- Presence of a fractured fragment or tumor in the spinal canal
- Presence of a bone infection or bleeding disorder
Risks and Complications of Thoracic Vertebroplasty
As with any surgery, some risks can occur with thoracic vertebroplasty. The general complications can include bleeding, infection, blood clots and reactions to anesthesia.
The specific complications following thoracic vertebroplasty can include leakage of the bone cement into the surrounding soft tissues or veins, and damage to the spinal cord or spinal nerves, leading to numbness or paralysis.