Vertebral Augmentation in Denver, CO
What is Vertebral Augmentation?
Vertebral Augmentation (Vertebroplasty/Kyphoplasty) is a minimally invasive procedure where medical grade “bone cement” is injected into fractures of the spine. Vertebroplasty is a same day outpatient procedure which is typically performed under conscious sedation. Under X-ray, a trocar needle is advanced through the skin and the lateral bone of the spine into the vertebral body. Once inserted the “bone cement” is injected. In kyphoplasty, a balloon is inflated in an attempt to restore height in the vertebral body prior to instilling cement.
Dr. Chris Warner has received extensive training at the Spine Fracture Institute at Clinical Radiology of Oklahoma. He has treated over 600 fractures in the past two years and is one of the leaders in Vertebral Augmentation in Denver, CO. Learn more about spine fractures and Vertebral Augmentation and schedule your consultation with Minimally Invasive Procedure Specialists today.
How are Spine Fractures Diagnosed?
Spine fractures can be painful and you should let your primary care physician or urgent care provider if you have back pain. An X-ray, CT scan or MRI will typically show compression of one or more of the vertebral bodies of the spine. MRI is typically the most useful because it can help determine the age of the fracture. In patients who cannot undergo an MRI and there is a question regarding the age of a fracture then a nuclear medicine bone scan may be ordered.
Causes of Spine Fractures
The vast majority of vertebral compression fractures are due to osteoporosis. They are typically found in elderly patients and more commonly in women than men as more women have osteoporosis. However, many elderly males also have osteoporotic
compression fractures. They can also be associated with cancers of the spine or cancers that have spread to the spine. The fractures can range from minimally painful to excruciating.
Fractures can result from a fall or other trauma, however, in patients with severe osteoporosis it may be due to bending, twisting, or picking something up. Many patients do not recall a specific event, but just the acute onset of pain. The pain is typically in the back and worse with transitions – going from lying to sitting, sitting to standing or vice versus. The pain often wraps around the rib cage. Pushing on the area or gently tapping is typically very painful.
Types of Vertebral Augmentation
Vertebroplasty is typically reserved for fractures with less than 20 percent height loss. If there is minimal pain and it does not limit the patient’s daily activities then we treat conservatively with over the count pain medications, opioids if needed, and physical therapy. If we choose this option, we will likely bring you back for follow up X-rays to make sure that the vertebral body is not compressing further.
Choosing between vertebroplasty and kyphoplasty is typically based on the amount of height lost in the vertebral body. If there is greater than 20 degrees of height loss then we proceed with kyphoplasty in order to try and restore as much height as possible and
restore the normal biomechanics of the spine.
What to Expect During Your Procedure
Our specialists use a curved needle and curved balloon (kyphoplasty) which allows for one sided access. The majority of fractures can be treated with only one small (5mm) incision instead of two. However, in severely compressed fractures we use a bilateral approach with two balloons or potentially an implant (SpineJack) to increase as much vertebral height as possible.
In fractures that are the result of a cancerous bone lesion we will use a radiofrequency probe to ablate the tumor prior to cement fixation. The radiofrequency probe goes through the same access point and no additional incision is needed. We also specialize in complex fractures – fractures associated with spine hardware or that are high in the thoracic spine.
The procedure itself is typically about an hour or less and patients go home the same day. Most patients receive conscious sedation through an IV although in some cases we will use monitored anesthesia care or general anesthesia depending on the overall health of the patient.
The bone cement has hardened before you are off of the procedure table, however, recovery is typically several hours due to the sedation. Most patients experience an immediate and significant reduction in their pain. Prior to the procedure you will not be able to eat or drink anything after midnight the day of the procedure. If you are on blood thinners those will need to be stopped 2-7 days prior to the procedure depending on the anticoagulant.
A follow up appointment will be scheduled for 2 weeks and at that time we will address any underlying osteoporosis to ensure that we prevent future fractures.
Recovering from Vertebral Augmentation
As mentioned above the procedure is a same day outpatient procedure. Pain relief is typically immediate. There will be some post procedure soreness from the needle access site. Some patients experience muscle spasms which can be treated with medications or
if needed trigger point injection.