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Vertebroplasty

Reinforcement of vertebrae by bone cement injection

  • the most gentle method, with immediate results
  • very short duration of anaesthesia
  • the patient usually leaves hospital the day after surgery
  • suitability of the method for each specific case must always be determined by a doctor

A high percentage of elderly patients suffer from back pain because they have a weakened vertebral structure caused by osteoporosis. Osteoporosis not only causes pain, but it also threatens its bearer with fractures and subsequent deformation of the spinal column. Vertebroplasty is a modern treatment method that has recently been undergoing widespread application in this field. We apply the required amount of bone cement to the affected vertebral body from a skin puncture with a thick needle under X-ray control. In this way we manage to strengthen the vertebral body and very reliably reduce or eliminate pain. We also remove the risk of fracture and in advanced age the frequency of deformity of the thoracic and lumbar spine.

Besides removing the general risks of a large operational procedure and risks related to narcosis, we see the main benefits as the possibility to leave the bed on the day of operation and the removal of risks associated with the often complicated healing of operation wounds. However, this method is only suitable for a select group of patients.

Vertebroplasty of thoracic vertebrae for an osteoporosis patient

As an illustrative case, a 61-year-old patient was lifting a heavy load when his back started hurting. He described about a month of pain at the thoracic lumbar transition. On the side scan traumatic changes are evident in the vertebral bodies Th 11 and 12. Magnetic resonance screening provided further information on traumatic changes to the 10th thoracic vertebra. Similar changes to vertebrae, especially in regard to their cause, are typical for patients whose spines are affected by osteoporosis (loss of bone mass). Examination of the bone mass of the spine (bone densitometry) also showed osteoporosis.

The patient underwent percutaneous puncture vertebroplasty, during which we injected 5 ml of bone cement into Th 11 and Th 12 from the left-hand side. 2 hours after the operation the patient was walking and stopped feeling pain and the next morning he was discharged to continue treatment in a specialized osteoporosis outpatient clinic.

Use of vertebroplasty in the treatment of tumours

Vertebroplasty can be simultaneously used for the treatment of selected tumours. With regard to the performance of the procedure under local anaesthetic, we can also offer it to patients whose health condition would otherwise rule out a surgical operation.

The tumours which vertebroplasty can very effectively resolve include vertebral hemangiomas. These are benign neoplasms whose growth distorts the bone structure, which may result in the formation of pathologic fractures.

One such case was that of a 53-year-old patient with a hemangioma of the 2nd vertebra, who had suffered from years of back pain. The CT scan showed the typical thinning of trabecular bone, with large cavities in the vertebral body containing tumour mass. Magentic resonance confirmed the limitation to the vertebral body area.

The patient underwent vertebroplasty, during which we punctured the affected vertebral body in an approach from both sides and after screening the efferent vein system we filled the vertebra with