PERCUTANEOUS VERTEBROPLASTY


PERCUTANEOUS VERTEBROPLASTY Percutaneous Vertebroplasty is a promising new therapy for the treatment of painful compression fractures refractory to conservative treatment. This procedure significantly reduces pain and restores mobility in the majority of appropriate candidates thus allowing patients to return to their previous quality of life. In this procedure, a needle is inserted through the skin and into the crushed vertebra. A special bone cement is injected into the bone in order to stabilize it. More than one vertebral body can sometimes be treated in a single procedure. Open surgery is not required due to utilization of fluoroscopy. The procedure takes one to two hours to perform depending upon the number of bones being treated. Vertebroplasty is performed at both Rapides Regional Medical Center and CHRISTUS St. Frances Cabrini Hospital by Drs. Alfred Mansour and Stephen Rice.Referrals can be made through the consultation line at (318) 448-9462.

	Dr. Al Mansour	Dr. Stephen Rice
VERTEBROPLASTY

Percutaneous Vertebroplasty is a minimally invasive fluoroscopically guided procedure used in the treatment of painful vertebral body compression fractures. This procedure was developed in France and has gained acceptance in the United States over the last 6 years. It is used primarily as a therapy for painful ostoporotic compression fractures that have been unresponsive to medical regimens.
More than 28 million Americans have thinning bones and are at risk for osteoporosis. Patients most often learn that they have osteoporosis after they seek medical treatment for a strain, twist of the body, bump or fall that has caused a bone fracture. Fractures may occur in the hip, wrist, or ribs; however, the most common fracture site(s) occur in the vertebral column. This affects 700,000 to 1,000,000 patients annually in the United States with associated health care costs estimated at 10 billion dollars. The lifetime risk of a vertebral body compression fracture is 16% for women and 5% for men. It is anticipated that the incidence of osteoporotic fractures will increase four-fold world-wide within the next 50 years. Pain is associated with approximately 84% of vertebral body compression fractures, leaving patients bedridden and dependent on analgesics. Bone loss is associated with immobilization which compounds the problem. These disabled patients are more susceptible to DVT, pneumonia and pulmonary embolisms. In most instances pain lasts for 4-6 weeks, however there are cases where the pain lasts for months or never fully subsides. It is not uncommon for these patients to experience a decrease in exercise tolerance, suffer weight loss and depression.

Percutaneous Vertebroplasty is performed as an outpatient procedure most often under IV sedation rather than general anesthesia. Normally the patient is discharged within 2-3 hours post procedure. There is some bruising at the injection site and a minimal amount of soreness that is experienced as a result of the procedure. In many cases patients report a substantial improvement in their pain level prior to discharge from the hospital. Therapeutic drugs, anticonvulsants, chemotherapy, heparin (secondary osteoporosis) and primary osteoporosis (age related) are the most common etiologies of vertebral compression fractures. This disease affects over two hundred million women worldwide. Women are affected twice as often as men with the disease with one in four women contracting the disease after they reach the age of 50. Clinical Indications / ICD-9 Codes: Osteoporotic fracture refractory to medical therapy Benign or malignant tumor (733.09): hemangioma (228.0) multiple myeloma (203.0) metastatic lesion (199.1) Osteonecrosis (733.02) Unstable fractures with movement at wedge deformity (733) Structural reinforcement prior to surgical stabilization (724.9) Multiple thoracic compression deformities with decreased thoracic cage threatens pulmonary compromise (738.5)