Vertebroplastik

Vertebroplasty is a minimally invasive medical procedure in which bone cement is injected into a fractured vertebral body through a needle under imaging guidance to stabilize the fracture and relieve pain. It is typically used for vertebral compression fractures due to osteoporosis, but may also be used for fractures caused by metastases or trauma.

The procedure is performed percutaneously, usually through a transpedicular or parapedicular approach under local anesthesia with sedation or general anesthesia. Real-time fluoroscopic radiation or CT guidance is used to position the needle and monitor cement injection. Polymethylmethacrylate PMMA cement is prepared to a viscous state and injected into the vertebral body; the amount and rate are monitored to minimize cement leakage. After cement solidifies, the needle is removed and the patient is monitored for a short period.

Indications include persistent pain from vertebral compression fractures not responding to conservative care and physical therapy, with the goal of rapid pain relief and improved mobility. Contraindications include active spinal infection, uncorrectable coagulopathy, allergy to cement components, or other conditions that make the procedure unsafe. Caution is advised in cases with extensive canal compromise, or when cement leakage into the spinal canal or venous system could cause harm.

Outcomes and risks: many patients experience rapid pain relief within 24 to 72 hours and improved function, though results vary. Potential complications include cement leakage (often asymptomatic but can cause neural irritation or compression), infection, bleeding, pulmonary cement embolism, and adjacent vertebral fracture. Vertebroplasty is sometimes compared with kyphoplasty, which uses a balloon to restore vertebral height before cement injection.