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Spine Surgery Guide

Vertebroplasty Surgery

What happens before surgery?

You may be scheduled for pre-surgical tests (e.g., blood test, electrocardiogram, chest X-ray) several days before surgery. In the doctors office you will fill out paperwork and sign consent forms so that your surgeon knows your medical history (allergies, medicines/vitamins, bleeding history, anesthesia reactions, previous surgeries, etc.).

What happens during surgery?

There are five steps to the procedure. The operation generally takes 1 hour for each vertebra treated.

Step 1 Prepare the patient
You will lie on the operative table and be given conscious sedation. Once sedated, you will be positioned on your stomach with your chest and sides supported by pillows. Depending on the section of the spine (cervical, thoracic, or lumbar) where the compressed vertebra is located, your back or neck will be cleansed and prepped.

Step 2 Insert the needle
A local anesthetic is injected in the area where a small, half-inch skin incision will be made over the fractured bone. With the aid of X-ray fluoroscopy (C-arm), two large diameter needles (11 or 13 gauge) are inserted into the vertebral body through the pedicles (Fig 2). The fluoroscopy monitor allows the surgeon to see exactly where the needles are positioned and how far they are inserted. The needles are advanced through the bone using either a twisting motion or a tapping mallet. The needles are angled to avoid the spinal cord.

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Step 3 Restore vertebra height (kyphoplasty only)
If the vertebra is significantly wedge-shaped, the surgeon will insert inflatable bone tamps (balloons) through the needles into the vertebra. To insert the balloon tamps, the surgeon first uses a drill to create a working channel. Your surgeon carefully inflates the balloons, raising the vertebra back to its normal height (Fig. 3). The amount of height restored depends on the age of the fracture. The balloons are deflated and withdrawn, leaving a space in the middle of the vertebra. This procedure is called kyphoplasty because it reduces unwanted kyphosis, or forward curvature, before the bone is stabilized.

Step 4 Inject bone cement
Bone cement is slowly injected under pressure, filling the deepest area first, then withdrawing the needle slightly to fill top areas (Fig 4). The pressure and amount of cement injected are closely monitored to avoid leakage into unwanted areas. While complete filling of the vertebral body is ideal, it is not always possible or necessary for pain relief.

Step 5 Closure
The needles are withdrawn promptly before the cement sets. The small skin incision is closed with steri-strips. You will not be moved from the operating table until the remaining cement in the mixing bowl hardens.

What happens after surgery?

You will return to the recovery area. Your blood pressure, heart rate, and respiration will be monitored, and your pain will be addressed. You'll remain lying down for the first hour after the procedure. After 1 hour you may sit up. After 2 hours you may get up and walk. Most patients stay in the hospital overnight for observation and are released the next morning. Some patients can be released home the same day.
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This information is not designed to replace a physician's independent judgment about the appropriateness or risks of a procedure for a given patient.
Always consult your doctor about your medical conditions or back problem. We Care Health Services does not provide medical advice, diagnosis or treatment. Use of the site is conditional upon your acceptance of our Terms and Conditions is a member of the medical tourism information network

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