Commonly known as PV, this surgical procedure represents hopes for the millions of people suffering from back pain due to osteoporosis and spinal compression fractures. The dowager’s hump suffered by so many aging women is a typical manifiestation of the aging process affecting the spinal column and resulting in loss of height and pain. “Oh my aching back!” could be the mantra of the elderly. PV can also be used on patients whose bone fractures are the result of cancer metastasis into the spinal column, and of course, these patients may not be elderly at all. Relief is out there in the form of a very ingenious procedure, which literally involves cementing the bone back together, replacing the part that has been eroded away with a compound that is similar in texture to the bone itself.
It’s an awful mouthful, but percutaneous means injected through the skin, and vertebroplasty is a combination of two words, vertebral- bodies in the spinal column- and plasty, a surgical procedure for replacement or restoration of a body part. So percutaneous vertebroplasty simply means an injection into the spinal column.
PV is minimally invasive. When the diagnosis of spinal fractures has been made by Xray, the surgeon pierces the skin into the area of a collapsed vertebra with a hypodermic and injects a compound called polymethylmethacrylate into the spinal fracture.The cement hardens in about twenty minutes and becomes a permanent part of that vertebra. The cement is mixed both with antibiotics to prevent infection and a barium powder to allow the surgeon to see the placement of the cement under an Xray machine while the material is being injected. Usually, after a short rest, the patient can get up and walk out of the operation area on his own.
PV is being performed at certain hospitals, medical centers and physicians’ offices throughout the US, employing some 300 interventional radiologists trained to use the technique. With some estimated 700,000 spinal compression fractures due to osteoporosis occurring every year, 80% in post-menopausal women, these qualified surgeons will never run out of patients.
Side effects of the PV precedure occur in only one percent of patients receiving the injection. These can include bleeding, another fracture, pain or weakness, infection and paralysis.
A comprehensive book on percutaneous vertebroplasty is available from Amazon. Unfortunately it is expensive, about $100.00. Percutaneous Vertebroplasty (Hardcover)
by John M. Mathis (Editor), Herve Deramond (Editor), Stephen M. Belkoff (Editor).
The reader is also referred to these selected articles:
http://www.emedicinehealth.com/vertebral_compression_fracture/article_em.htm
http://depts.washington.edu/ccor/studies/vplasty.shtml
http://www.aafp.org/afp/20020815/611.html
