At first, the main symptom was treatment of spinal hemangiomas, illustrated by Galiber Etal in the year 1987. With the passage of time and application, effectiveness in other conditions has been detected. Vertebroplasty may enhance mobility in patient, prevent more vertebral collapse and reduce narcotic requirements.
Osteoporotic Vertebral Rupture
Osteoporosis is made difficult by vertebral fracture, which takes place impulsively or is caused by trauma of minor nature. In USA, the occurrence of compression fractures is observed among five hundred thousand patients annually, that is more than the numbers of hip fractures. Risk of osteoporotic vertebral rupture is five percent in men and sixteen percent in women. These fractures of vertebral are very often extremely painful and are treated with analgesic medicines, immobilization and particular treatment of osteoporosis.
Immobilization is increased with demineralization and symptoms of initial nature likely to go away within four to six weeks time. Despite of longer period medical treatment, few patients have persistent, severe and incapacitating pain. Subsequently, effects of vertebral fracture result in kyphosis, reduced height and chronic type of back pain.
In vertebral metastasis which has remained untreated so far, experiencing pain, radiotherapy is fruitful in seventy percent of patients to reduce spinal pain, however this effect is time taking and may needs two to six weeks.
Characteristically, vertebroplasty is a sedative treatment which provides more rapid analgesia.
Vertebroplasty has been utilized effectively in relentless central spinal pain with unaggressive radiological vertebral haemangioma.
Pre- procedure Patient Evaluation
One has to make appropriate history confirmation and conduct a short body examination to ensure the effectiveness of the method, which is localizing softness on palpation, is not related with vertebroplasty response of superior type.
Positioning and Set Up
The total time required in order to complete the procedure is between thirty minutes to one hundred twenty minutes. Local anesthesia and conscious sedation are utilized in majority of the patients. One has to consider Prophylactic antibiotics and patient has to be placed in the horizontal position. One has to bring into line posterior ribs to get a perfect lateral view and locate the obliquity which displays the pedicle above the upper outer third portion of the vertebral body along with marking of this point has to done.
Injection Procedure and Polymethylmethacrylate Mixing
One has to mix barium sulphate and polymethylmethacrylate according to the instruction of manufacturer and then inject slowly this mixture, until the vertebral body is filled well, making sure to stop prior to PMMA posterior leaks into the area of epidural or fills a vein significantly. However, various practitioners try to fill up the body of vertebral as totally as possible, and one should take note of the thing that relief of pain is not related with volume of cement.
Post Procedure Care
Patients has to be kept on bed rest for one to two hours. As required, analgesics administration for postoperative pain and for important muscle spasms muscle relaxants are to be performed. Physician has to make sure that the primary care of patient is medically controlling osteoporosis and if it is not done, management should be introduced. Twenty percent of patients having a rupture develop a second time fracture if the systemic osteoporosis therapy is not done. In respect of systemic treatment of osteoporosis comprises lifestyle changing like alcohol moderation, excise and smoking cessation, DEXA scans, proper supplementation of diet and managing medically. The dietary supplement includes vitamin D and Calcium intake. More or less, these are the prime things to be taken care of in the post procedure care.