Percutaneous Vertebroplasty

 

What is Percutaneous Vertebroplasty?

 

This is a method for treating fractures of the spine caused by osteoporosis or tumors.  Each year in the U.S., 700,000 new spine fractures occur due to osteoporosis.  These fractures result in 115,000 hospital stays for pain control.  Once you have had one vertebral compression fracture (spine fracture), your risk is five times greater for more fractures.  The pain that occurs after the collapse of a vertebra can be intense and deep.  You may be confined to bed or a wheelchair for a while.  This pain may last for 4 – 10 weeks.  Pressing on the site of the fracture will cause the pain.  The collapse of a vertebra most often occurs in the middle of the spine, but may occur higher up in the thoracic spine or lower in the lumbar spine, near the tailbone.

 

This pain is often treated with bedrest, pain relievers, and a back brace.  However, if these treatments are not effective, the patient and his/her doctor may choose percutaneous vertebroplasty.  During this procedure, a needle is placed through the skin (percutaneously) into the painful vertebra.  The doctor watches progress of the needle with a fluoroscope x-ray machine.  The doctor will inject some glue (like glue used to “cement” a hip replacement) into the collapsed vertebra.  The glue makes it strong and stops further damage.  The main goal of this “internal casting” of the vertebra is to ease pain and strengthen the vertebra.  The success rate is about 80 to 85%.

 

Who Does This Procedure Help Most?

 

This is designed to help the patient who does not gain pain control from other treatments.  The patients that respond the best have had their fracture pain for six months or less.

 

If you have not improved with other treatments, you may be a candidate for this procedure.  You will have X-rays and either a CT scan, MRI scan, or bone scan of your back.  A radiologist who specializes in vertebroplasty will review your X-rays and talk about your case with your doctor.  They will then decide whether this treatment might help your pain.

 

Preparation

 

• You cannot eat for 8 hours before the procedure.
• You may take your medicines with a sip of water.  If you take insulin for diabetes, you should take one-half (½) your scheduled morning dose on the morning of the procedure.
• You must have a friend or family member drive you to the hospital and take you home.
• You will be asked to stop taking aspirin starting seven days before the procedure.
• Tell the doctor if you are taking Coumadin® for blood clots, heart rhythm problems, or an artificial heart valve.  In these cases, more planning will be needed before the procedure is done.  Other blood thinning medicines, such as Plavix® should also be discussed.
• Tell the doctor if you have allergies to any antibiotics, iodine, or soap.

 

Procedure

 

On the day of the procedure, you will meet a doctor from the Department of Diagnostic Radiology.  Enter the hospital through the clinic entrance and take the Atrium elevators to the 3^rd floor.  Then check in at the (G3/3) Radiology desk.  All questions, concerns, risks and benefits will be explained to you in detail by the doctor.  After your questions have been answered, you will sign a consent form.

 

You will change into a hospital gown.  An intravenous (IV) line will be placed in your vein by the nurse in the prep room.  At this point, you will be brought to the procedure room on a cart.  You will be transferred to a procedure table which will have extra padding on it to support you as you lie face down.  A nurse will give you medicine to relax you and lessen your pain.  During this time, your blood pressure, oxygen level, and heart rate will be checked often.  The fractured vertebra will be found using a fluoroscope (X-ray).  The skin over the vertebra will be cleaned with iodine-based soap.  After cleaning your back, a sterile drape will be put over it.  Guided by a fluoroscope, one and sometimes two needles are passed through the skin and into the collapsed vertebra.  Once the needles are in the proper place, the doctor will inject the cement.  The cement makes the collapsed vertebra stable and may relieve the pain.  Then, the needle(s) will be removed.  At times, two or three vertebrae will be treated at the same visit.

 

After the Procedure

 

Once the procedure is over, you will be transferred to the recovery room and closely watched.  Your blood pressure, heart rate, and oxygen level will be checked.  You will be watched for the next 2 to 3 hours in the hospital.  After that time, you will be allowed to go home.  A nurse will call you several days after the procedure.  The doctor will see you back in clinic in 2-3 weeks.  It is okay to shower, but no tub baths, hot tubs, or swimming for at least 3 days.  Leave your dressings on for at least three days.

 

You or one of your family members should call the doctor if any of these symptoms occur.

• Sudden onset of pain that travels down the leg.
• Sudden onset of weakness of the arm or leg.
• Sudden onset of shortness of breath or it becomes worse.
• If the area around the site becomes red, swollen, or more painful.  You have a white or yellow pus or drainage from the site.  You have a fever greater than 100.4º F or 38º C.
• New onset of rib pain.

 

Phone Numbers

 

• Musculoskeletal Nurse Coordinator: (608) 263-6871
• After 5:00 p.m. or weekends, call (608) 262-0486.  This is the message center.  Ask for the Bone Radiologist.  Leave your name and phone number with the area code.  The doctor will call you back.  If you live out of the area, call 1-800-323-8942.
• If you need to reschedule, call (608) 263-XRAY (9729) between 8:00 a.m. to 5:00 p.m.
• If you are in of immediate help, call 911 or go to the nearest Emergency Room.

 

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 05/20/2010

Copyright © 05/20/2010 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. UWH #5685

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