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At Cedars-Sinai Marina del Rey Hospital, our team of neurosurgeons strongly believe in a patient-centered treatment approach. Our highly skilled surgeons use minimally invasive techniques whenever possible. After a careful evaluation, our surgeons will explain your treatment options and help you make the right decision regarding surgical management. In addition, our well-trained physical therapists will advise a rehabilitation program to help you get back to your normal routine faster.
Percutaneous vertebral augmentation (PVA) is a minimally invasive spinal surgical procedure meant to stabilize the spine when the vertebral bodies collapse as a result of injury or osteoporosis. PVA involves the injection of bone cement into the broken vertebral body. There are two surgical techniques by which a PVA can be performed: vertebroplasty and kyphoplasty. Both of these procedures help reduce the pain associated with vertebral compression fractures. They can also restore lost vertebral height. PVA is a procedure that is both safe and effective. It offers significant pain relief while allowing for a faster recovery and a smaller likelihood of post-operative complications.
PVA is used to treat vertebral fractures that are common in people with osteoporosis, osteonecrosis, and tumors. These conditions make your vertebral body weak and more susceptible to fractures. Common cancerous osteolytic lesions that may lead to fractures of the vertebral body include myeloma and metastatic tumors, such as breast cancer, lung cancer, thyroid cell carcinoma, and renal cell carcinoma.
Your surgeon will advise you to take certain precautions prior to surgery. Taking prescription drugs, over-the-counter medications such as blood thinners (Coumadin and aspirin), and nonsteroidal anti-inflammatory drugs (NSAIDs) should be stopped at least one week before the procedure. You will also need to follow your doctor's instructions regarding eating and drinking habits on the days leading up to your surgery. If you take regular medication for high blood pressure or diabetes, you will need to inform your surgeon.
There are two different approaches to the percutaneous vertebral augmentation surgery: vertebroplasty and kyphoplasty. Both of these procedures involve the placement of a cement-like substance into the damaged vertebral body. Vertebroplasty involves direct injection of the cement into the vertebrae, while kyphoplasty makes use of a balloon to expand the injection site.
Vertebroplasty: This procedure is performed under mild anesthesia. With the help of an imaging technique known as C-arm fluoroscopy, the surgeon will inject a cement material (polymethylmethacrylate) into the vertebral body. This material takes about 30 minutes to harden. The entire procedure lasts between 1-2 hours. After a brief period of observation, you will be able to return home.
Kyphoplasty: This procedure is used in osteoporotic spinal fractures that involve the collapse of the frontal part of the vertebrae, where the vertebrae is compressed into a wedge shape. Kyphoplasty is a two-step procedure that is performed in a hospital, under a local or general anesthesic. The surgeon will make a small incision on the back, then insert a balloon device into the compressed vertebrae in order to restore its normal shape. The space created by the balloon is then filled with bone cement, which hardens to maintain the vertebral height. The entire procedure will require about one hour for each vertebra, and most often you will be allowed to go home on the same day.
As PVA is a minimally invasive surgical procedure, it offers a series of benefits over traditional surgical procedures, which include:
As with any surgical procedure, PVA may cause complications, though they tend to be less severe. The most common complication associated with PVA is cement leakage, which occurs in anywhere from 27% to 75% of cases. In these instances, the cement most often leaks into the intervertebral space. As a result, there may be an increased risk of fracture in the vertebra adjacent to the one treated with PVA. Other less common types of complications include infection, bleeding, embolism (if cement enters the blood stream, and fractured ribs.
You will be allowed to return home after a short period of recovery at the hospital. Your surgeon will give you a series of post-operative instructions, which include:
Are you looking for pain relief options for your spinal disorders? You can learn more about percutaneous vertebral augmentation, and other services, by getting in touch with the specialists at Cedars-Sinai Marina del Rey Hospital.
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