Vertebroplasty

Copyright 2008 Spine Care Hong Kong

SPINE CARE HONG KONG

ACCURATE DIAGNOSIS, STRUCTURED TREATMENT

In Vertebroplasty bone cement is injected into the collapsed vertebra to stabilize it. In acute fractures a degree of reduction may be possible.

The main risk is that during the procedure there may be cement leakage, either into the spinal canal causing canal stenosis and possibly cord compression, or that the cement extravasates into the vertebral venous plexus and ends up as a cement embolus which may have more serious consequences.

Vertebroplasty is indicated to treat painful pathological fractures of the vertebrae.

Examples would include osteoporotic fractures, and fractures secondary to pathological bone destruction as in cases of tumour metastases and in cases of multiple myeloma.

CASE ILLUSTRATION

Male 73 years old

Known history of multiple myeloma with cervical spine involvement and surgery for posterior instrumentation with pedicle screws for stabilization.

He presents with a sudden onset of lower back pain for 1 week with no history of trauma or injury.

Blood investigations show a grossly elevated ESR and total protein level.

X rays of his lumbar spine MRI and CT were arranged

CT scan with multiple lytic lesions and collapse of L4 vertebra

Bone Biopsy and 2 Level vertebroplasty is performed with pain reduction from VAS 9/10 to VAS 1/10 at day 1 after the procedure.

2 level vertebroplasty L3 and L4

Kyphoplasty

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