What Are the Risks of Vertebroplasty?

Percutaneous vertebroplasty (PVP) is a procedure used to treat and stabilize vertebral (spinal) fractures. The process involves using a type of imaging called fluoroscopy, which provides X-rays in real time, to enable a doctor to inject a concrete-like fast-setting polymer into the damaged vertebrae. 

A procedure called kyphoplasty often accompanies vertebroplasty. Kyphoplasty is the insertion and inflation of a balloon in the vertebrae before the cement delivery. This helps to repair loss of height in fractured vertebrae and restore alignment. 

The doctor may use a SpineJack kyphoplasty system, which uses titanium implants in the bone that work together in the bone with the cement-like polymer to create a more stable outcome, reduce post-procedure pain, and better restore vertebral body height.

Percutaneous vertebroplasty is used to:

• Treat pain in vertebral (spinal) compression fractures
  • Women have a 16% lifetime risk of getting a vertebral compression fracture, due to the higher risk of osteoporosis in women (men’s lifetime risk is 5%)
• Treat collapsed vertebrae from osteoporosis 
• Treat spinal damage due to certain cancers and spinal tumors
• Stabilize weakened vertebrae prior to surgery
• Help repair alignment of vertebrae due to kyphosis
• Pain from vertebral hemangioma

Before the vertebroplasty is performed, the doctor will formulate a plan to best treat the damaged vertebrae. This may include: 

• Medical history and physical exam
• CT scans
• X-rays
• MRI of the spine
• Blood tests 
• Complete blood count (CBC)
• Chemistry panel
• Coagulation panel (PT/PTT)

The actual vertebroplasty procedure may last between 30 minutes to two hours. 

• Patient is placed in the prone position (face down)
• The area of the back around the damaged vertebrae is cleansed thoroughly with antiseptics to prevent infection
• Anesthesia is administered for conscious sedation 
• Local anesthesia (such as lidocaine with epinephrine) is placed in the back at the level of the damaged vertebrae using a needle
• X-rays are performed using fluoroscopy to ensure proper localization of the damaged vertebrae and to guide placement of the cement compound 

After the procedure

• Patients are put on bed rest for up to 2 hours
• Pain medications may be given
• Muscle relaxants may be given for muscle spasms
• Patients receive detailed follow-up instructions 
• Patients are usually discharged the same day with a family member or friend who can help them after the procedure. 

Complications from vertebroplasty are usually minimal and only occur in 1% to 10% of cases. 

Possible complications may include:

• Infection in the skin or vertebrae
• Worsening of spinal fracture, especially when the original fracture is due to cancer
• Damage to spinal cord or adjacent nerves
• Paralysis
• Allergic reaction to anesthetic or cement-like compound
• Bleeding
• Collapsed lung
• Cement migration – cement compound leaks into surrounding tissues or bloodstream