Doctors at Samaritan Hospital are offering a new treatment for the relief of back pain associated with spinal compression fractures, usually caused by the progressive bone loss of osteoporosis.

The minimally invasive procedure called percutaneous vertebroplasty is a non-surgical, outpatient procedure that involves inserting a cement-like material into the center of the collapsed spinal vertebra in order to stabilize and strengthen the crushed bone. With the patient under a local anesthetic, an interventional radiologist inserts a needle into the fractured area of the spine and then, using guided imagery such as CT scanning and fluoroscopy, fills the cavity with a medical-grade epoxy or glue. Shortly after injection, the cement-like material hardens creating a supportive structure that prevents further collapse of the vertebrae and alleviates pain. The procedure takes less than an hour and patients are usually able to return home the same day.

Until recently, treatment options for vertebral compression fractures were limited to pain management with strong oral or intravenous medications, reduced activity, bracing or invasive back surgery with mediocre results. With vertebroplasty, the cement like substance does not impair movement of the spine and patients can move normally once the cement is in place. Vertebroplasty offers patients a promising alternative without the need for major surgery.

Figure A. An MRI of the spine in an elderly patient demonstrates advanced osteoporotic fractures due to long standing corticosteriod treatment. Due to severe intractable pain the patient was treated successfully at multiple levels by vertebroplasty.

Figure B. A view from another patient shows the large needle (arrowhead) advanced into the vertebral body and the cement (arrow) as it extrudes into the bone.

Figure C. A CT scan of this patient (C) shows the difference between the weaken bone and the dense cement (arrow).

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A. MRI with Compression Fractures	B. Transpedicular Placement of Needle and Cement Extrusion	C. CT following procedure with Intraosseous Cement