Vertebroplasty: Everything You Need to Know

Vertebroplasty is a procedure that involves injecting cement into vertebrae, the bones that make up your spine. Vertebroplasty is typically used to treat compression fractures, which can cause your vertebrae to collapse. This injury causes severe pain, spine instability, and sometimes nerve compression, making daily activities difficult.

This article overviews vertebroplasty and discusses preparation and what to expect during and after the procedure.

What Is Vertebroplasty?

Vertebroplasty is a minimally-invasive procedure typically performed as an outpatient procedure. During vertebroplasty, your surgeon injects medical-grade cement into the fractured vertebra, which then hardens to strengthen the bone.

Vertebroplasty can be performed under light sedation, a medication used to help relax you and prevent pain, and local anesthesia, where a provider will numb the area for the procedure. In some cases, your surgeon might use general anesthesia.

Your surgeon may use fluoroscopy to help with the placement of the injection. This technique uses a continuous x-ray beam to show the movement of the needle as the surgeon injects cement into the affected bone.

Related: Vertebroplasty and Kyphoplasty: Overview

Contraindications

Vertebroplasty is not appropriate for everyone. This procedure is contraindicated under these circumstances:

• Presence of infection
• Fractures that are not painful
• Uncontrolled bleeding disorder
• Tumors that have spread into the spinal canal
• Symptoms that can be relieved with conservative treatment
  
• Allergy to bone cement

Potential Risks

Although vertebroplasty is minimally invasive, there are potential risks, which can include the following:

• Infection
• Leakage of cement before it hardens
• Fever
• Fractures in nearby bones
• Excessive blood loss
• Irritation of nerve roots

However, only one to three percent of people experience complications from vertebroplasty.

Related: Understanding the Risks Involved When Having Surgery

Purpose of Vertebroplasty

Vertebroplasty is not typically the first line of treatment for compression fractures in the spine, except when the injury results from trauma rather than osteoporosis or cancer.

Your provider may recommend vertebroplasty when symptoms do not improve after several weeks of conservative treatment. Examples of treatment before vertebroplasty include:

• Pain medication
• Anti-inflammatory medication
• Physical therapy
• Muscle relaxants
• Hard or soft back brace
• Nerve blocks
• Epidural injection

Pre-Operative Evaluation

Before your provider schedules vertebroplasty, they will order imaging studies to assess the location and extent of damage in your spine. These studies often include the following:

• X-rays: This test is beneficial for identifying where a compression fracture occurred.
• MRI (magnetic resonance imaging): This test helps to identify tumors and other soft tissue damage.
• CT scan (computer tomography): This test provides more detailed information about bone damage found on the x-ray.
• DEXA scan (dual energy x-ray absorptiometry): If your compression fracture is related to weakened bones, you'll likely have a DEXA scan performed to assess your bone density.

How to Prepare

While pre-operative instructions vary by procedure and health care provider, there are some things that occur with most types of surgery. Be sure to follow your healthcare provider's instructions carefully to reduce risk of having your procedure postponed.

Location

Your vertebroplasty may take place in a hospital or free-standing surgery center. Scope out your location ahead of time, so you aren't late on the day of surgery.

What to Wear

Dress in comfortable, loose-fitting clothing that you can put on easily after surgery. Consider wearing slip-on shoes with tread for safety. Leave all jewelry at home, and avoid using makeup or skincare products before your procedure.

Food, Drink, and Medication

Before surgery, your provider will instruct you to stop eating and drinking fluids a certain number of hours before your procedure. They might also advise you to stop taking certain medications ahead of time, such as blood thinners and anti-inflammatory medications.

What to Bring

Be sure to bring your picture ID, insurance card, list of current medications, and a form of payment if a co-pay is due at the time of service. You'll need to bring someone with you to drive you home after surgery.

What to Expect on the Day of Surgery

The hospital or surgery center will ask you to arrive a few hours before your procedure to check in and fill out essential paperwork.

Before the Procedure

Preparation for your procedure begins in a pre-operative room where you'll change out of your clothing into a hospital gown. You will have your vitals taken—blood pressure, heart rate, oxygen saturation, and respiratory rate—and a nurse will put an intravenous line (IV) into your arm to deliver medications during your procedure.

Before surgery, your surgeon will review the procedure and method of anesthesia and tell you what to expect after surgery. Be sure to ask questions ahead of time since you might not remember much immediately after your procedure.

During the Procedure

Once in the operating room, you will be given medication through your IV to sedate you, and the surgical team will thoroughly clean your skin.

Your surgeon will then insert a needle filled with cement at the level of the affected vertebra, using fluoroscopy as a guide. Once the cement is in the bone, you'll remain sedated while it hardens, typically for one hour. The injection site will be covered with a bandage.

After the Procedure

After vertebroplasty, you'll be transferred to a post-operative area while your sedation wears off. A nurse will monitor your vital signs and give you medications to help control your pain. Recovery is different for everyone but typically lasts up to two hours.

Your nurse will review your post-operative instructions, including what you can do for pain management and activities you should avoid.

Recovery After Vertebroplasty

For optimal vertebroplasty recovery, follow your surgeon's specific instructions.

The bandage over the injection site should be kept dry for 24 to 48 hours. You can remove it when the site is no longer draining.

To help with soreness, apply ice to the area several times per day, for up to 20 minutes at a time, with a thin towel between the ice pack and your skin. Take your pain medication as prescribed.

You'll be encouraged to walk after the procedure, but twisting and bending are often restricted for several weeks. Lifting can be restricted for several months.

You might also participate in physical therapy to help you safely regain function and strength after vertebroplasty.

Summary

Vertebroplasty is a procedure that involves injecting cement into cracked vertebrae to strengthen the bone after a fracture. It is performed on an outpatient basis, under local or general anesthesia. Initial recovery lasts a couple of weeks, but your activities can be limited for several months.

A Word From Verywell

Vertebroplasty is only performed when conservative treatment fails to relieve pain from vertebral fractures. Talk to your healthcare provider about other treatment options to determine whether this procedure is appropriate for you.