Nowdays, there is a very effective intervention for solving osteoporotic vertebral fractures. Vertebroplasty is a minimally invasive intervention, which is practiced in CODRA Hospital Neurosurgery Center. Vertebroplasty solves the fracture of the vertebrae of the spine in awake patients, without a classic incision, under local anesthesia.
Having in mind that usually candidates for vertebroplasty are elderly patients with numerous comorbidities, this type of intervention is ideal for them because it is performed under local anesthesia. Patients with osteoporotic vertebral fractures, whose pain does not go away after three weeks of conservative treatment (wearing an orthosis, resting and adequate analgesia), are candidates for vertebroplasty, as are patients with metastatic osteolytic changes, in whom the posterior bone wall is preserved. The effectiveness and success of this procedure, primarily in the regression of acute pain and stabilization of the segment, according to today’s literature, is about 90%. In most cases, pain decreases almost immediately after vertebroplasty, in others within 48 hours.
The vertebroplasty method is performed under local anesthesia, percutaneously, by inserting a needle with a diameter of about 1.5 mm, through a puncture in the skin and under the control of an X-ray machine and placing it in the body of the vertebra. Then, liquid “bone cement” polymethyl methacrylate (PMMA) is applied to the body of the vertebra, which dries and hardens after a short time (about 15 minutes) and thus stabilizes the fractured vertebra relieving patient’s pain.
On regular basis Dr. sc. med. Nenad Živković performs vertebroplasty with bone cement of the latest generation – “Confidence” made by “Johnson&Johnson”. Cement is characterized by high viscosity, with no liquid phase. With the help of a hydraulic applicator and with excellent X-ray control, the cement is safely applied to the body of the vertebra. In this way, the complications of liquid cement were additionally avoided. The intervention itself, in addition to local anesthesia, can also be performed with mild sedation. The procedure lasts a maximum of one hour, observation for another two hours, after which the patient is released from the hospital. Bed rest is advised for the first 24 hours after the procedure, followed by gradual verticalization and return to normal life activities. Returning to more strenuous physical activities, such as participating in sports or heavy lifting, is not advised until six weeks later.
Advantages of vertebroplasty:
- One-day surgery under local anesthesia,
- Short and efficient procedure,
- Permanent solution to a vertebral fracture,
- No cut,
- Quick removal of pain