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:: Vertebroplasty
Vertebroplasty was developed in 1984 and has since then proven to be a safe and effective treatment for symptomatic compression fractures. The procedure involves direct injection of bone cement into the affected vertebral body using fluoroscopic guidance.Its advantages include low cost, excellent safety profile (< 1% major complications for osteoporotic fractures and < 5% for pathologic fractures), and a high level of clinical efficacy (80% clinical success in osteoporotic fractures and 50% success in pathologic fractures). |
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Vertebroplasty can be performed on an outpatient basis and requires only 2 hours of recovery time. The vertebroplasty procedure takes an average of 20 minutes to complete a single level, and is well tolerated by patients under conscious sedation. Given the markedly lower cost, the shorter procedure and recovery times, and the ability to perform the procedure on an outpatient basis without the added risk of general anesthesia, we will strongly favor vertebroplasty over kyphoplasty in the treatment of symptomatic compression fractures. |
Typical Causes of Compression Fractures
- Vertebral Body Compression Fracture
- Primary osteoporosis
- Secondary osteoporosis
More common in females than males.
1.5 Million osteoporotic fractures
Annual Cost in the US
- 500,000 - 700,000 vertebral fractures
- (1995 osteoporotic fracture data)
- 2.5 million physician visits
- 432,000 hospital admissions
- 180,000 nursing home admissions
- $13.5 billion in direct medical costs
Early Intervention May Reduce:
• Duration of acute pain
• Height loss
• Duration of immobilization
• Use of analgesics
• Occurrence of chronic pain
• Incidence of pneumonia
• Further collapse of the treated vertebral body
Treatment Options:
• Analgesics
• Bed Rest
• Immobilization
• Surgery
• Demineralization
Benefits Of Vertebroplasty
Pain Relief Improved Mobility
Quick Mobility within 24 hrs
Complete
Efficacy
Osteoporotic compression fracture
- 80-90% of patients experience dramatic or complete relief of pain immediately or within 72 hours.
Indications
- Pain related to vertebral compression fractures associated with osteoporosis or tumor infiltration.
Contraindications
- Uncorrected coagulpathy or systemic or spinal infection.
- Moderate to severe retropulsion of the posterior vertebral body cortex into the spinal canal.
- Height loss>70%
Example:
Case #1: Painful osteoporotic compression fracture.
 
 
Complete symptomatic relief within 24 hrs.
The procedure has a low complication rate and a very high success rate.
Vertebroplasty is a palliative procedure and does not correct the underlying cause of the vertebral fracture.Medical management of osteoporosis or malignancy must therefore be initiated and continued.
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