Vertebroplasty is a micro-invasive surgical procedure that is performed to strengthen the damaged body of the spine by introducing bone cement. The procedure is performed in the presence of a fracture of a spinal vertebra. Vertebral fracture can occur in osteoporosis, haemangioma, traumatic injury to the back, metastases in the vertebrae, and in the presence of spinal tumours.
Bone cement is introduced into the vertebral body through a special needle, and the manipulation is controlled by X-rays.
The essence of the method is that the surgeon inserts a metal needle into the body of the damaged vertebra, through which a special mixture is injected. The mixture consists of bone cement, contrast material and antibiotic.
The speed of hardening of the mixture and the duration of its existence in a pasty state is the most important characteristic of bone cement – this is because during this period (6-11 minutes) the surgeon must inject the substance and fill the fracture. The hardening of the bone cement is heated to a temperature of 70 ° C, providing support to the body of the damaged vertebra and exerting a cytotoxic effect on the cells of the pathological neoplasm. Injected cement strengthens the vertebral body, which allows not only effective treatment of the effects of vertebral compression fractures but is also used to treat pain caused by tumour metastases in the spine or vertebral haemangiomas.
Most often, vertebral haemangiomas with signs of aggressiveness require vertebroplasty. A criterion for evaluating the aggressiveness of this pathology is intense back pain aggravated by physical exertion, combined with a lesion of the chest of the greater part of the body of the spine and a cellular structure detected by nuclear magnetic resonance (MRI) or computer tomography (CT). The main indication for the need for surgical manipulation is based on back pain localized at the level of the lesion. Vertebroplasty is often required for pathological fractures of the vertebral column.
Before starting to perform the procedure, the specialist must carefully follow what the patient's complaints are, what caused the trauma and whether there is a need to apply the procedure, as he must assess whether there are grounds for contraindications to the application.
The procedure is characterized by a high degree of efficiency. The purpose of applying the procedure is to reduce the severity of pain, combined with preservation of motor activity, significantly improving the quality of life of patients undergoing surgery. For this reason, vertebroplasty is increasingly used in the treatment of compression fractures of the spine. Vertebroplasty is performed under local anaesthesia and mild sedation (the patient is sedated but remains conscious). To prevent possible complications, the patient is given antibiotics. The patient is placed on his stomach. After local anaesthesia is performed on the projection area of the affected vertebra, a metal wire is inserted into its body through a small incision – 5 to 7 mm. After the introduction of the cement is completed, the surgical wound is sutured, and a bandage is applied. After performing the microinvasive manipulation, the patient must rest in a supine position for at least 1-2 hours. Before starting the procedure, it is mandatory to consult a specialist who has extensive experience and professional skills for the application, and this is most often a neurosurgeon. The consultation is carried out by taking an anamnesis from the patient (explanations from the patient about the cause of the trauma, what the pain is, how long it has been, what diseases the patient has, and other additional questions asked by the specialist). It is mandatory for the patient to have an imaging scan (MRI or CT scan, according to the specialist's requirements after taking the history), which must be carefully examined in order to familiarise the patient with the procedure, its execution, and give his opinion on whether it is suitable for him, what are the advantages and disadvantages according to his individual condition and health status, as well as what would be the possible complications in the application and.
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