Disc herniation is a disease wich can affect patients of any age. It may result secondary of trauma, from injuries to the spine, different accidents or, in some cases, there isn’t an identified cause ( in this case the disease is know as idiopathic disc herniation).
A herniated disc consists of tiny tears or cracks in the outer layer (annulus or capsule) of the disc. The jellylike material inside the disc (nucleus) may be forced out through the tears or cracks in the capsule, which causes the disc to bulge, break open (rupture), or break into fragments. This is causing severe and constant pain. The disc hernia can lead to a root compression provoking a quality of life degradation.
Vertebroplasty is a pain treatment for vertebral compression fractures that fail to respond to conventional medical therapy, such as minimal or no pain relief with analgesics or narcotic doses that are intolerable. A compression fracture occurs when pressure on a vertebra causes it to break or crack, often because of osteoporosis. Compression fractures are often extremely painful, and can cause abnormal spine curvature that leads to other serious health problems.
Vertebroplasty, a nonsurgical treatment performed by interventional radiologists using imaging guidance, stabilizes the collapsed vertebra with the injection of medical-grade bone cement into the spine. The cement hardens, stabilizing the fractures and supporting your spine. This reduces pain, and can prevent further collapse of the vertebra, thereby preventing the height loss and spine curvature commonly seen as a result of osteoporosis. Vertebroplasty dramatically improves back pain within hours of the procedure, provides long-term pain relief and has a low complication rate, as demonstrated in multiple studies.
When vertebroplasty is successful, the cement mixture injection stabilizes the vertebra and allows you to return to normal activity after a recovery period.
If the vertebra isn’t shored up, it can heal in a compressed or flattened wedge shape. Once this occurs, the compression fracture cannot be treated effectively. It is very important for someone with persistent spinal pain lasting more than three months to consult an interventional radiologist, and people who require constant pain relief with narcotics should seek help immediately.
The main reason you would need a vertebroplasty is treat a fractured vertebra in your spine that’s causing pain and reduced function. Not all people with fractured vertebrae are candidates for a vertebroplasty, however. Your doctor may try other, more conservative methods of treating the pain first: bed rest, pain relievers, muscle relaxants, back braces, or physical therapy.
These are reasons that your doctor may consider a vertebroplasty for your fractured vertebra:
Traditional methods of treating your fractured vertebra or back pain fail.
You suffer from severe or prolonged pain or immobility.
The fractured vertebra has led to more serious complications, such as deep vein thrombosis, acceleration of osteoporosis, respiratory problems, loss of height, or other emotional or social issues.
Your compression fracture is less than six months old, and imaging tests (X-rays, MRI and bone scan) can pinpoint the location and age of the compression fracture.
Your bones are not so weakened (porous) that your ribs might break as a result of lying facedown during the procedure.
Vertebroplasty may also be applied prophylactically to an at-risk vertebra between 2 other abnormal vertebra.
Vertebroplasty has several benefits:
1. Return to normal activity. Many people with compression fractures are unable to do everyday tasks because of the pain. Vertebroplasty stabilizes the fracture, allowing most people to resume previous levels of activity within a few days.
2. Reduced pain medication. Vertebroplasty reduces and sometimes eliminates the need for pain medication.
3. Prevention of further fractures. The cement fills the spaces in bone weakened by osteoporosis. The treated bone is less likely to crack or fracture again.
Because the injection of acrylic under pressure is likely to pass through the fracture into the spinal canal, a posterior cortical defect is considered a relative contraindication for vertebroplasty.
Cord compression, radiculopathy.
Vertebroplasty also is contraindicated in cases involving a bone infection such as diskitis with osteomyelitis.
The presence of a burst fracture with loss of integrity of the posterior vertebral cortex and retropulsion of a fracture fragment into the spinal canal is considered exclusionary.
Fever and/or sepsis.
addBefore procedure - Preparation
This procedure is often done on an outpatient basis. However, some patients may require admission following the procedure. Please consult with your physician as to whether or not you will be admitted.
Tell your doctor yf you’re pregnant.
Prior to the intervention, your doctor must be prevented about any history of allergic reactions. Blood tests are taken including hemoglobin level, coagulation, renal function, and other specific tests.
Your doctor will explain the procedure to you and offer you the opportunity to ask any questions that you might have about the procedure. You will be asked to sign a consent form that gives permission to do the procedure.
Notify your doctor if you are sensitive to or are allergic to any medications, latex, iodine, tape, contrast dyes, and anesthetic agents (local or general).
Based on your medical condition, your doctor may give you other specific preparation instructions.
addAfter procedure - Recovery time
Once the procedure is complete and the cement has hardened, you will likely remain in an observation room for an additional 1 hour to 2 hours. This will allow the doctor to make sure that the procedure was successful. You will then likely be able to stand and walk with little or no pain.
You may experience pain relief almost immediately after the procedure, but for some people it takes up to 72 hours. Many people can resume their normal daily activities immediately. Your doctor may provide you with over-the-counter pain relievers to help ease the discomfort.
Before you are discharged from the hospital, the doctor will probably perform an assessment of your pain and check for any possible complications. You can also expect a follow-up office visit in the coming weeks to make sure that the procedure has continued to be successful for you. Sometimes your doctor may want to continue to brace your back after the procedure, but often this is unnecessary.
Is it painful?
Vertebroplasty is not painful and requires only mild sedation and analgesia. If you are in severe pain, general anesthesia may be required.
How long does it take?
Vertebroplasty usually takes one hour for each vertebra that is treated.
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