Cement Augmentation/Ballon Vertebroplasty

Cement Augmentation/Ballon Vertebroplasty for the Low/Mid Back

What is it?

Cement augmentation/balloon vertebroplasty is a minimally invasive procedure that can help relieve pain and restore mobility caused by compression fractures in the spine. Compression fractures are cracks or breaks in the spinal bones (vertebrae) that result from osteoporosis, cancer, trauma or other conditions that weaken the bone.

How does it work?

The procedure involves injecting a special type of bone cement into the fractured vertebra through a small needle. The cement fills the cracks and stabilizes the bone, preventing further collapse and reducing pain. The procedure is done under local or general anesthesia and usually takes about an hour.

In some cases, a balloon may be inserted into the vertebra before the cement injection. The balloon is inflated to create more space and restore the height of the bone. Then the balloon is deflated and removed, leaving a cavity that is filled with cement. This technique is called kyphoplasty and may reduce the risk of cement leakage.

What are the benefits?

Cement augmentation/balloon vertebroplasty can provide immediate or rapid pain relief for many patients with compression fractures. It can also improve function, quality of life, and emotional well-being. It can reduce the need for pain medications and prevent complications such as deep vein thrombosis, respiratory problems, loss of height and spinal deformity.

What are the risks?

Cement augmentation/balloon vertebroplasty is generally safe and effective, but like any procedure, it has some potential risks and complications. These include:

  • Cement leakage. The cement may leak out of the vertebra and press on the spinal cord or nerves, causing new symptoms such as numbness, weakness or paralysis. The cement may also enter the bloodstream and travel to other organs such as the lungs, heart, kidneys or brain, causing damage or even death. However, these events are very rare and usually do not cause serious problems.
  • Additional fractures. The procedure may increase the pressure on the adjacent vertebrae, leading to new fractures in the future. This risk may be higher for patients with severe osteoporosis or multiple fractures.
  • Infection. The needle insertion site may become infected, requiring antibiotics or surgery.
  • Bleeding. The needle may cause bleeding in or around the spine, which may require a blood transfusion or surgery.
  • Allergic reaction. The anesthesia or cement may cause an allergic reaction, which may require medication or emergency care.

Who is a candidate?

Not everyone with compression fractures is a candidate for cement augmentation/balloon vertebroplasty. Your doctor will evaluate your condition and determine if you are eligible for the procedure based on factors such as:

  • The cause, location and severity of your fracture
  • The duration and intensity of your pain
  • Your medical history and overall health
  • Your response to conservative treatments such as bed rest, pain relievers, muscle relaxants, back braces and physical therapy

You should discuss with your doctor the pros and cons of cement augmentation/balloon vertebroplasty and other treatment options available for your condition.

How to prepare?

Before the procedure, your doctor will order some tests such as X-rays, MRI or CT scans to confirm the diagnosis and plan the procedure. You will also need to provide your medical history and inform your doctor about any medications or supplements you are taking, especially blood thinners or anti-inflammatory drugs. You may need to stop taking some of them before the procedure.

You will also need to avoid eating or drinking for several hours before the procedure. You should wear comfortable clothing and leave your jewelry at home. You should arrange for someone to drive you home after the procedure.

What to expect?

During the procedure, you will lie face down on a table. You will receive sedation medication to help you relax or general anesthesia to put you to sleep. Your doctor will use X-ray guidance to insert a needle into your fractured vertebra through a small incision in your skin. Your doctor will then inject cement into the bone through the needle. If a balloon is used, it will be inserted first and inflated before injecting cement.

You will feel some pressure during the needle insertion and cement injection. You may also feel some warmth as the cement hardens. The procedure will take about an hour or longer if more than one vertebra is treated.

After the procedure, you will be moved to an observation room for one to two hours. You will be monitored for any signs of complications such as fever, bleeding or nerve irritation. You may experience some soreness at the injection site or temporary pain increase while the cement cures. Your doctor will prescribe you some pain relievers for this discomfort.

You will be able to go home on the same day or stay overnight in the hospital if needed. You should follow your doctor’s instructions on how to care for your wound, when to resume your activities and medications, and when to schedule a follow-up visit.

Sources

The information on this page is based on the following Internet resources: