Spine Knowledge Lecture 3: How much do you know about PVP vertebroplasty?

Today I will briefly introduce what is vertebroplasty. Vertebroplasty is an operation mainly for senile osteoporotic compression fractures.  

There are two treatments for compression fractures in the elderly: one is bed rest for about one to two months; the other is a minimally invasive surgery.

other members will ask me: “My grandparents are in their 80s, and they are older, can they still have this surgery?” In fact, the older you are, the more you need this surgery, because if you don’t have surgery, it may cause further osteoporosis. aggravated. This time it may be a broken pot, and the next time it may be broken by a sneeze. So I recommend surgery on the patient, but this surgery must have several characteristics:

    ❖ First, minimally invasive

    ❖ Second, fast recovery

Vertebroplasty satisfies both of these points.

01. What is Vertebroplasty?

We build a bony channel in the bone, and inject bone cement into the vertebral body through a one-centimeter wound, so that the patient’s fracture can be glued and the properties of bone cement can be used to relieve pain, and the patient can walk on the ground on the same day.

◆ Basic principles of vertebroplasty

The balloon is placed through the working channel.

The balloon is pressurized outside the body by a pressure pump.

Negative pressure to remove the balloon.

Bone cement is injected into the cavity. The height of the vertebral body is restored, and the strength is restored.

Note: Part of the content is transferred from the public account “Bone Language Youyun”, the copyright belongs to the original author, and is only used for learning and communication.

02. Surgical risks and countermeasures?

Any surgery can have risks, and vertebroplasty has risks:

◆ First, bone cement reaction

Doctors can circumvent this by injecting cement slowly.

◆ Second, bone cement leakage

For the leakage of bone cement, the doctor can also avoid it by slowly injecting the bone cement. Once a slight leakage is found, the doctor can immediately stop the injection of the bone cement. 

  Now some operating rooms have been equipped with three-dimensional C-shaped arms. With the assistance of three-dimensional C-shaped arms, we can see whether the bone cement is leaking in all directions? Under the guidance of precise imaging, we can inject more bone cement into the patient and try to avoid postoperative complications of bone cement penetration. In addition, we can use the three-dimensional C-arm to perform another inspection after surgery to see the diffusion of bone cement in the vertebral body to ensure that the operation is successful.

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