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Vertebroplasty: Procedure, Uses and Risks

Vertebroplasty is a minimally invasive procedure used to treat vertebral compression fractures. Bone cement is injected into the fractured vertebra to relieve pain and restore spinal stability.

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Things worth knowing about "Vertebroplasty"

Vertebroplasty is a minimally invasive procedure used to treat vertebral compression fractures. Bone cement is injected into the fractured vertebra to relieve pain and restore spinal stability.

What is Vertebroplasty?

Vertebroplasty is a minimally invasive, image-guided procedure used in interventional radiology and orthopedics. It involves injecting a special bone cement (polymethylmethacrylate, PMMA) directly into a fractured or unstable vertebral body. The primary goals are to stabilize the vertebra, reduce pain, and prevent further spinal deformity. The procedure is typically performed under local anesthesia with continuous imaging guidance using fluoroscopy or computed tomography (CT).

Indications

Vertebroplasty is primarily used in the following conditions:

Osteoporotic vertebral compression fractures: Spinal fractures caused by reduced bone density (osteoporosis)
Pathological fractures: Vertebral fractures resulting from bone metastases or multiple myeloma
Painful vertebral hemangiomas: Benign vascular tumors within the vertebral body causing significant pain
Acute and chronic pain following vertebral compression fractures that do not respond adequately to conservative treatment

Procedure

The procedure is typically performed on an outpatient basis or with a short period of inpatient observation:

The patient lies face down in the prone position.
After local anesthesia, a thin hollow needle is carefully guided through the skin into the affected vertebral body under continuous imaging control.
The liquid bone cement is slowly injected and hardens within a few minutes.
Following the procedure, the patient is monitored for several hours before discharge.

Vertebroplasty vs. Kyphoplasty

Vertebroplasty is closely related to kyphoplasty, but differs in one key step: in kyphoplasty, a balloon is inserted into the vertebral body and inflated before cement injection to create a cavity and partially restore vertebral height. In vertebroplasty, the cement is injected directly without prior balloon preparation. Kyphoplasty may also help correct spinal kyphosis (hunching of the spine) in addition to relieving pain.

Expected Outcomes

Many patients experience significant pain relief within 24 to 72 hours after the procedure. Clinical studies demonstrate that the majority of patients with osteoporotic vertebral fractures achieve a meaningful improvement in quality of life and mobility. The hardened cement provides long-term structural support to the treated vertebra.

Risks and Side Effects

Vertebroplasty is generally considered a safe procedure. Possible risks and complications include:

Cement leakage: Cement may escape into surrounding tissue, the intervertebral disc, or blood vessels – usually without symptoms, but rarely with neurological consequences
Infection at the puncture site or within the vertebra (rare)
Adjacent fractures: Neighboring vertebrae may fracture due to altered load distribution
Allergic reactions to the bone cement (very rare)
Bleeding or nerve injury (very rare)

Contraindications

Vertebroplasty is not suitable in cases such as:

Recent, stable fractures without significant pain
Active infection (e.g., spondylitis, osteomyelitis)
Uncorrectable coagulation disorders
Severe spinal canal stenosis with neurological symptoms

References

Voormolen MH et al. - Percutaneous Vertebroplasty Compared with Optimal Pain Medication Treatment: Short-term Clinical Outcome of Patients with Subacute or Chronic Painful Osteoporotic Vertebral Compression Fractures. AJNR Am J Neuroradiol. 2007; 28(3): 555-560.
Buchbinder R et al. - Percutaneous Vertebroplasty for Osteoporotic Vertebral Fracture. Cochrane Database of Systematic Reviews. 2015; Issue 4.
American Academy of Orthopaedic Surgeons (AAOS) - Clinical Practice Guideline: Management of Hip Fractures in the Elderly. 2021.

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