Percutaneous vertebroplasty is a procedure designed to treat local pain originating from a compression fracture involving a vertebral body of the spine. This procedure is performed using x-ray guidance to accurately place a medical grade cement into a partially compressed vertebral body. This cement-like material is injected in liquid form through a needle placed through the skin and into the vertebral body after local anesthesia is applied to the skin and involved bone. This procedure has been very successful in relieving pain associated with vertebral collapse in appropriately selected patients. In most of the patients we have treated, the vertebral body collapse has been associated wiith mineral loss [a process where bone mineral loss is due to aging or the use of bone wasting medicines]. This procedure treats only the fractured vertebra and does not reverse the process of osteoporosis generally or prevent future compression fractures.
The following information is provided in an attempt to clarify the intended use of this procedure. We suggest that you discuss this procedure with your local physician and let them be involved in deciding whether or not the problem that you have seems amenable to this type of therapy. We will be glad to review your x-rays and medical case history here at UVA and subsequently discuss with you the possibility of performing percutaneous vertebroplasty. Patient selection is very important as the treatment is specific for pain associated with simple vertebral fracture and compression. This treatment should not be utilized, nor expected to be effective, for the treatment of degenerative disc disease, disc herniation, or compression of the spinal cord or its associated nerve roots. Also, vertebral bodies must still retain a portion of their original height if successful injection of the medical cement is to be expected. [This means that we need to treat the vertebral body before complete collapse occurs]. Standard radiographs [x-rays] of the spine are used to identify a collapsed vertebral body. A neurologic examination should show that there is only local pain associated with this vertebral collapse. There should not be pain in other areas or radiation of pain that would suggest nerve compression.
If these criteria are met, then there is a very good chance that percutaneous vertebroplasty will be successful at reinforcing the fractured bone and alleviating local pain. It must be borne in mind that this is a new medical procedure about which we are continually gaining information. To date the procedure has been very successful at pain relief. However, all medical procedures carry associated risk. Infection, bleeding, and compression of adjacent nerve tissue are all possible side effects of this type of procedure. We sincerely hope that this information has been helpful in deciding whether or not the problem that you have may be amenable to this therapy. Once again, we will be happy to consult with you or your physician if you wish to seek therapy here at UVA.
Preparing for Vertebroplasy
Once it is determined that a vertebroplasty is needed you will be seen by a Neuroradiologist or Nurse Practitioner for a complete history. Please bring a list of your medications with you. You will be required to have labs drawn as part of this workup. Your procedure will be done in the Neuroradiology department using conscious sedation. You will be positioned on the X-ray table face down. An IV will be used to give you pain medication and and sedation to keep you comfortable. The procedure takes 1 to 3 hours, depending on how many levels are being treated.
How to Prepare
You are not allowed to eat after midnight the day of the procedure. You may drink clear liquids up until 2 hours before your procedure time.
Where to Go the Day of the Procedure
You will need to check in at Radiology reception one hour prior to your scheduled procedure time. This will give us time to get you ready. One of the staff will pick you up once you have registered.
Prior to your Procedure
The nurse will do an assessment and start an IV. The neuroradiologist or nurse practitioner will explain your procedure, answer any questions and have you sign a consent form. A pre-procedure assessment will be performed.
During your Procedure
You will be lying prone on the table and monitored closely. You will be given local anesthetics, pain medication and sedation. Once the procedure is over you will remain on the table for 10-15 minutes to allow the cement to fully harden.
After your Procedure
You will be returned to the stretcher and go to the recevery room where you will flat on your back for about a hour. Once stable, you will be allowed to sit up and go home. Detailed discharge instructions will be given to you and your family members. You will need someone to drive you home
Billing and Insurance
If you are a self-pay patient, a bill will be issued at time of service and mailed to your home.
If you are covered by a commercial health insurance carrier, please bring your cards or proof of coverage should be brought with you the day of your study. We will file your claim for you. Please note that you will be billed for any balance not covered by your plan. If you belong to a Health Maintenance Organization (HMO) or Preferred Provider Organization (PPO) with which we have a contract, you must bring the referral and authorization form for the procedure to be covered.
If your visit is due to an accident (work-related, automobile, etc.), you must provide us with an authorization from the guarantor of your bill.
Note that separate bills are issued by the UVA (to cover facilities, equipment, and support personnel) and the Health Science Foundation (to cover the services of the physician neuroradiologists). So expect to see two bills for your study.
For additional information on the web, we recommend you click on the link below to visit the ACR and RSNA patient information site: