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Vertebroplasty/Kyphoplasty

Vertebroplasty and Kyphoplasty are minimally invasive procedures for vertebral compression fractures (VCF), which are fractures in vertebra, the small bones that make up the spinal column. In Vertebroplasty, physicians use image guidance to inject a special cement mixture through a hollow needle into the fractured bone. In Kyphohplasty, a balloon is first inserted through the needle into the fractured bone to restore the height and shape of the vertebra. Once the balloon is removed, the cement mixture is injected.

Vertebroplasty and Kyphoplasty are used to treat pain caused by vertebral compression fractures in the spine. Typically, Vertebroplasty is recommended after simpler treatment, such as bed rest, a back brace or pain medication, have been ineffective, or once medications have begun to cause other problems, such as stomach ulcers. Kyphoplasty is performed on patients experiencing painful symptoms or spinal deformities due to vertebral compression fractures resulting from osteoporosis.

A clinical evaluation including diagnostic imaging, blood tests, a physical exam, spine X-rays and a radioisotope bone scan or magnetic resonance (MR) imaging will be done to confirm the presence of a compression fracture that is can be treated with Vertebroplasty or Kyphoplasty. You may be given bone-strengthening medication during treatment. On the day of the procedure, you should be able to take your usual medications with sips of water or clear liquid up to three hours before the procedure. You should avoid drinking orange juice, cream and milk. In most cases, you may take your usual medications, especially blood pressure medications. These may be taken with some water in the morning before your procedure. You may be instructed not eat or drink anything for several hours before your procedure. You will need to have blood drawn and tested prior to the procedure to determine if your blood clots normally. You should plan to have a relative or friend drive you home after your procedure. You will be given a gown to wear during the procedure.

In both Vertebroplasty and Kyphoplasty procedures, X-ray equipment, a hollow needle or tube called a trocar, orthopedic cement, barium powder and a solvent are used. For Kyphoplasty, a device called a balloon tamp is also used. The equipment typically used for this examination consists of a radiographic table, an X-ray tube and a television-like monitor that is located in the examining room or in a nearby room. When used for viewing images in real time (called fluoroscopy), the image intensifier (which converts X-rays into a video image) is suspended over a table on which the patient lies. When used for taking still pictures, the image is captured either electronically or on film. A Foley catheter may be placed in your bladder. Other equipment that may be used during the procedure includes an intravenous line (IV) and equipment that monitors your heart beat and blood pressure.

Vertebroplasty involves injecting a special cement mixture into the small holes in weakened vertebrae to strengthen the spinal bones making them less likely to fracture again and providing pain relief. Using image-guidance, a hollow needle called a trocar is passed through the skin into the spinal bone and a cement mixture is then injected into the vertebra. In Kyphoplasty, a balloon is first inserted through the tube and into the fractured vertebra where it is inflated to push the bone back to its normal height and shape. The balloon is then removed and the cement is inserted into the cavity created by the balloon.

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