What is veebroplasty ?
Ans. is 'a' i.e., Stabilization of veebral compression fracture Veebroplasty is an outpatient procedure for stabilizing compression fractures in the spine. Bone cement is injected into back bones (veebrae) that have cracked or broken, often because of osteoporosis. The cement hardens, stabilizing the fractures and suppoing jour spine. Veebroplasty and kvphoplasty Veebroplasty and kyphoplasty are interventional radiologic procedures for the treatment of the intense pain refractory to medical management or bracing caused by veebral compression fracture associated with osteoporosis, tumors, and trauma. Veebroplasty and kyphoplasty involve intraosseous injection of acrylic cementpolymethyl methacrylate under local anesthesia and fluoroscopic guidance. Pain reduction or elimination is immediate, and the risk of complications is low. Neither veebroplasty nor kyphoplasty are intended for the treatment of interveebral disc disease or ahritis. Veebroplasty may also be applied prophylactically to an at-risk veebra between 2 other abnormal veebrae. Veebroplasty does not restore the height of the compressed veebral body. A related procedure, kyphoplasty, is intended to restore lost height by inflating a balloon pump within and between the fracture fragments prior to the infusion of the cement. Both procedures result in similar relief of pain due to veebral compression fractures. The risks of the procedure are low and include extravasation of cement into the epidural space causing myelopathy, or fatal pulmonary embolism from extension of cement into paraspinous veins. Indications for percutaneous veebroplasty Osteoporotic veebral compression fractures more than two weeks old in the cervical, thoracic, and lumbar spine causing moderate to severe pain and unresponsive to conservative therapy. Painful metastasis and multiple myeloma with or without adjuvant radiation or surgical therapy. Painful veebral hemangiomas Veebral osteonecrosis. Reinforcement of a pathologically weak veebral body before a surgical stabilization procedure. Contraindication for percutaneous veebroplasty Contraindications are : - 1. Absolute Osteoporotic veebral fracture that is completely healed or is clearly responding to conservative management. Presence of untreated coagulopathy. Presence of discitis/osteomyelitis (septic or tubercular) or sepsis. 2. Relative Significant compromise of the spinal canal by retropulsed bone fragment or tumor. Fracture older than one year. Greater than 80-90% collapse of the veebral body.
Stabilization of veebral compression fracture
Replacement of veebral body only
Replacement of veebral body with interveebral disc
Fusion of the adjacent veebrae