Vertebroplasty is a medical procedure designed to address painful vertebral compression fractures, which commonly affect the spine. This minimally invasive intervention involves the precise injection of a specialized bone cement directly into the fractured bone. The primary objectives of vertebroplasty are to provide immediate pain relief for patients and to stabilize the weakened vertebral body. This stabilization helps prevent further collapse and can improve a patient’s mobility.
Understanding Vertebroplasty and Bone Cement
Vertebroplasty is a procedure that treats vertebral compression fractures, often resulting from conditions like osteoporosis or certain cancers. During the procedure, medical professionals use imaging guidance, such as X-rays, to precisely insert a hollow needle into the fractured vertebra. Through this needle, a medical-grade bone cement, typically polymethylmethacrylate (PMMA), is injected into the affected bone.
This cement, which has a consistency similar to toothpaste, fills the cracks and spaces within the damaged vertebra. Once injected, the PMMA hardens quickly, usually within minutes, creating an internal cast that stabilizes the fractured bone. The hardened cement prevents further collapse of the vertebra and reduces the movement of bone fragments that cause pain, alleviating discomfort and improving mobility.
The Durability of Vertebroplasty Cement
The polymethylmethacrylate (PMMA) bone cement, once hardened within the fractured vertebra, is designed to be a permanent fixture. It does not degrade, dissolve, or get absorbed by the body over time, remaining intact within the treated vertebral body for the patient’s lifetime.
While the cement itself is permanent, its overall effectiveness in maintaining spinal health and preventing new issues can be influenced by other factors. These influencing elements relate more to the surrounding bone and the patient’s overall condition rather than the cement degrading.
Factors Influencing Cement Longevity
The cement’s functional effectiveness in supporting the spine can vary based on several factors. A primary element is the patient’s underlying bone quality, particularly the severity of osteoporosis. Weaker bone density can affect how the treated vertebra interacts with adjacent segments, even with the cement in place.
The extent of the initial fracture, including the presence of intraosseous clefts, can also influence outcomes, as these might alter the biomechanical properties of the treated segment. The occurrence of new fractures in vertebrae adjacent to the treated one is another important consideration. These “adjacent level fractures” can happen due to altered load distribution, as the stiffened, cemented vertebra may transfer more stress to the neighboring bones. Studies indicate that vertebrae adjacent to treated levels can have a significantly increased risk of fracture.
Cement leakage during the procedure, though often asymptomatic, has also been identified as a factor that might increase the risk of adjacent vertebral fractures. Patient activity levels and lifestyle choices also play a role; while they don’t impact the cement directly, they affect the overall health of the spine and the likelihood of new fractures occurring elsewhere.
Long-Term Considerations for Vertebroplasty
Following vertebroplasty, the treated vertebra maintains stability due to the permanent bone cement. This structural support helps alleviate localized pain and maintain the treated bone’s form.
Despite this localized stability, the underlying bone weakness, such as osteoporosis, often persists throughout the rest of the spine. This ongoing fragility means new compression fractures can still occur in other vertebrae. The cement’s role is specific to the treated vertebra; it does not strengthen other parts of the spine.
Therefore, managing the underlying condition, such as osteoporosis, through medication, diet, and lifestyle adjustments, remains important to minimize the risk of future fractures in other areas of the spine. Long-term studies have shown that patients often continue to experience significant pain relief and improved quality of life for many years after vertebroplasty, even if new fractures develop in untreated areas.