Treatment of spinal fractures by injecting cement to stabilize the spine (Vertebroplasty / Kyphoplasty) is a treatment for collapsed spinal fractures, which mostly occur due to osteoporosis and vertebral compression, or may result from accidents. This method helps reduce pain and increase the strength of fractured or collapsed vertebrae.
What symptoms indicate the need for surgery?
In treating collapsed spinal fractures, treatment usually starts with bed rest and taking or injecting painkillers (Conservative treatment) for 1-2 weeks. The fractured vertebrae can heal on their own within 2-3 months. However, if the patient has nerve or spinal cord compression caused by fractured bone fragments, vertebral displacement, or vertebral collapse due to spinal tumors, these patients require spinal surgery.
For patients who do not require surgery, if they have undergone bed rest and pain medication for several days but still experience pain, and the fractured vertebrae have not healed after several weeks, they should receive treatment by injecting cement to stabilize the spine. This method strengthens and stabilizes the fractured vertebrae with cement.
How is the cement injection to stabilize the spine performed?
The cement injection to stabilize the spine may be done under local anesthesia without general anesthesia, or under general anesthesia, depending on the patient’s condition, the amount of cement needed, and how long the patient can tolerate lying face down.
Steps of vertebroplasty (cement injection to stabilize the spine)
The patient lies face down on the operating table. Needle insertion into the vertebra requires the use of X-ray/fluoroscopy to locate the injection site. Then, a small incision of about 2-3 millimeters is made at the needle insertion site. The needle is inserted into the vertebra, and a radiopaque contrast agent is injected to check if the injection site is safe and to ensure there is no leakage of cement that could compress the spinal cord. Once the correct and appropriate site is confirmed, cement is injected into the vertebra to stabilize the fractured vertebra or strengthen the bone. During the cement injection, the doctor continuously monitors the X-ray images on the screen. After the cement injection, the patient is turned onto their back and lies supine for about 2-3 hours to allow the cement to harden. After that, the patient can sit up or stand.
Cement injection to stabilize the spine by lifting and expanding the collapsed vertebra (Kyphoplasty) is a method that can restore the height of the collapsed vertebra to near normal levels by using a balloon or expansion tool inserted into the collapsed vertebra through the needle used for cement injection, then injecting cement to stabilize the vertebra.
Although vertebral cement injection is a safe procedure, complications may still occur, though very rarely, including:
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- Excessive blood loss from the vertebra
- Rib fractures, mostly occurring in patients with osteoporosis
- Pneumothorax caused by the needle puncturing the pleural cavity during cement injection
- Cement leakage compressing the spinal cord. This rare but severe complication can cause paralysis of both legs and loss of bladder and bowel control
- Infection, divided into two types: skin infection and deep-seated infection. Skin infections can be treated by wound cleaning and antibiotics, but deep infections, such as infections of the vertebrae or intervertebral discs, may require surgery to remove the infected tissue if antibiotics are ineffective
