What Is Vertebroplasty?
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Vertebroplasty - Causes, Symptoms, Diagnosis, and Treatment

Published on Jan 03, 2023 and last reviewed on Jul 27, 2023   -  5 min read


Vertebroplasty is a medical procedure used to treat vertebral compression fractures. Read this article to learn more about vertebroplasty.


Vertebroplasty is an interventional radiological procedure used to relieve pain in patients with vertebral compression fractures. This procedure uses a special cement called PMMA (polymethyl methacrylate) that hardens inside the vertebra to support the fractured site. Vertebral compression fractures are a condition in which cracks and deformities the vertebra causes severe pain and decreases the height of the vertebra.

Vertebral compression fractures can occur from osteoporosis (a condition that makes the bone weak and brittle), accidents, infection, or malignancy. The thoracolumbar spine (T2-L2) is most commonly affected, followed by the lower lumbar region (L2-L5). Primary treatment options for vertebral compression fracture are analgesics (painkillers), physiotherapy, bed rest, and external orthosis (a band or appliance applies pressure to alter the function of the neuromusculoskeletal system).

According to the guidelines of the standards of practice committee of the society of interventional radiology, vertebroplasty is recommended in patients having painful vertebral fractures along with osteonecrosis (death of bone due to lack of blood supply), painful vertebral fractures with considerable osteolysis or patients with osteoporotic vertebral compression fractures which cannot be managed by medical treatment.

How Do the Patients Prepare for the Vertebroplasty Procedure?

  • Patients are advised to take any of the following imaging techniques, such as spinal X-rays, MRI (magnetic resonance imaging), or CT (computed tomography), before the procedure to confirm the vertebral fracture.

  • Medical conditions and regular medicines of the patients should be informed to the doctor.

  • The patient should inform if pregnant, prior to the procedure.

  • For osteoporosis patients, a dual-energy X-ray absorptiometry scan is advised (DXA) to confirm the compression fracture.

  • 1 gm of Cefazolin is given intravenously (IV) as a prophylactic antibiotic an hour before the procedure. In patients with Penicillin or Cefazolin allergy, 500mg of Vancomycin may be given as a substitute.

  • Patients are instructed not to take food or drink six hours before the procedure. They can take a small sip of water two hours before the procedure.

  • Patients might be advised not to drive or operate machinery for about 24 hours after the vertebroplasty procedure. They have to arrange for someone to bring them home.

What Are the Recommendations for the Vertebroplasty Procedure?

  • Patients who are taking Clopidogrel (an antiplatelet drug- a medicine that prevents aggregation of platelets) should stop taking them five days before the procedure with their physician's advice.

  • Patients who are taking low molecular weight Heparin (LMWH) are advised to skip one dose of Heparin (anticoagulant- a drug that prevents blood clot formation) before the procedure.

  • INR (international normalized ratio) or prothrombin time should be less than 1.5.

  • Transfusion is required when the platelet count is less than 50,000.

How Is the Vertebroplasty Procedure Performed?

  • Vertebroplasty is usually done by an interventional radiologist.

  • During this procedure, the doctor inserts an intravenous (IV) line into the veins in hand to deliver the sedative to make the patients feel relaxed and sleepy. The vertebroplasty procedure usually requires moderate sedation. Sometimes, patients with severe pain may require general anesthesia to help them hold in place and be comfortable during the procedure. The patient’s heart rate, BP (blood pressure), oxygen level, and pulse rate are monitored throughout the procedure.

  • Patients are asked to lie flat with their faces down on the procedure table. Then the nurse sterilizes the area where the needle will be inserted during the procedure. After that, a small incision is made through which the procedure is performed. In order to confirm the entry point, an anteroposterior X-ray view is taken.

  • With the guidance of imaging techniques such as contrast-enhanced fluoroscopy, a hollow needle or trocar is inserted into the front of the middle third of the vertebra, which is confirmed with a lateral X-ray view.

  • After confirming the final needle position with fluoroscopy, the mixed cement is injected into the vertebral body. Before injecting the cement, they should attain a paste-like consistency to prevent leakage into the surrounding structures. The cement is delivered evenly throughout the vertebrae by pulling back the needle slowly. Generally, 2.5 to 4 mL of cement is required to provide a good filling to a vertebra in osteoporotic fractures. AP (anteroposterior) and lateral X-ray views confirm the even distribution and no extravasation of cement outside the vertebra. When the cement reaches the posterior vertebral body, injection of cement is stopped. The vertebroplasty procedure takes about one hour to complete.

  • Patients are instructed to avoid aggressive exercises and lifting heavy weights for about six weeks after the procedure.

What Are the Contraindications of Vertebroplasty?

Vertebroplasty is not recommended under the following conditions:

  • Herniated disks (bulging out of the disc located between the vertebrae).

  • Arthritic back pain (swelling of the joints between the spine).

  • Patients with healed chronic vertebral fractures.

  • Scoliosis (abnormal lateral curvature of the spine) or kyphosis (abnormal forward curvature of the spine) results not from osteoporosis.

  • Severe bleeding disorder.

  • Local or generalized infection.

  • Allergic to the orthopedic cement- PMMA (polymethylmethacrylate).

  • A tumor (cancer) with spinal canal involvement.

  • Asymptomatic vertebral fractures.

  • The fracture extended up to the posterior vertebral body.

What Are the Complications Associated With Vertebroplasty?

  • Infection.

  • Bleeding at the injection site.

  • Damage to the spinal cord or nerve root.

  • Sometimes, patients may have pain at the injection site for two to three days after the procedure. Placing an ice pack on the injection site may comfort them.

  • There might be extravasation (leakage) of cement into the spinal canal, neuroforamen, paravertebral veins, or intervertebral disc (rubbery discs located between the vertebrae).

  • Chances of rare complications such as cement particles entering the lungs and spinal stenosis (narrowing of the spinal canal spaces) from cement extravasation.

  • New fracture adjacent to the compression fracture site.

  • The high temperature of cement during polymerization (85-degrees Celsius) causes thermal (heat) damage to surrounding tissues.

  • Neurological symptoms such as tingling (prickling sensation) and numbness (loss of sensation in body parts), and rarely paralysis.

  • Severe back pain.


Vertebroplasty is used to relieve extreme pain in patients with vertebral compression fractures. This procedure prevents the need for painkillers for patients with compression fractures on a daily basis. Vertebroplasty improves the patient's movement and gives structural support to the vertebra. The major advantage of vertebroplasty over kyphoplasty (a procedure used to treat vertical compression fracture in which a balloon is inserted into the vertebra, which is then inflated to create space for cement) is that it can be performed under local anesthesia or conscious sedation and general anesthesia is not required in every case as in kyphosis. Vertebroplasty is cost-effective when compared to kyphoplasty. Vertebroplasty usually provides immediate relief from the symptoms of vertebral compression fracture, or it may take up to 48 hours, and it may vary sometimes.

Frequently Asked Questions


Is Vertebroplasty a Serious Surgery?

Vertebroplasty is considered a minimally invasive surgery. In this surgery, the procedure is performed by creating a small puncture in the skin instead of an open incision. Depending on the healthcare provider, this can be performed under general or local anesthesia. This procedure is usually performed within one hour.


What Is a Vertebroplasty?

A vertebroplasty procedure is performed in cases of cracked or broken spinal bones. This procedure injects cement into these cracked spaces to relieve the pain. This is most commonly done in the case of injuries called compression fractures. These fractures are usually seen in osteoporosis, a condition that weakens the bones.


What Kind of Cement Is Used in Vertebroplasty?

The vertebroplasty procedure involves injecting cement into the collapsed vertebrae. The cement is injected using a fluorescent guide. The most commonly used bone cement in this procedure is polymethyl methacrylate (PMMA) to treat compression fractures. It is injected into the fractured vertebrae to attain immediate augmentation, relief of pain, and patient mobility improvement.


What Is the Cost of Vertebroplasty?

The vertebroplasty cost may depend on factors such as medical conditions, hospital location, and the surgeon's practice. The average cost of vertebroplasty and kyphoplasty in India starts from $5,000 to $8,000, and in other countries like the USA, the cost may range from $4,200 to  $13,000, varying among different locations.


How Successful Is Vertebroplasty?

Vertebroplasty is considered an effective and safe procedure for treating vertebral compression fractures. This is a minimally invasive method that does not cause complications. According to various studies, the success rate of this procedure is 73 to 90 percent.


Is Vertebroplasty Risky?

Vertebroplasty is usually a simple and safe procedure that rarely causes any compilations. It is generally well tolerated, and the complications seen in this procedure are minor and have a tendency of one to three percent. However, like any other surgery, it does have some potential risks. As this procedure is performed close to the spinal cord and other important nerves, an error in the needle placement could result in damage that causes weakness or paralysis in one or more limbs.


Is It Okay to Walk After Vertebroplasty?

Vertebroplasty is a safe and effective procedure with a short duration. The patient may be able to walk home on the same day of the procedure. Moreover, walking is considered very important for healing and rehabilitation, and the patient is advised to walk at least two to three times daily as it will increase tolerance for pain while doing physical activities.


What Is the Recovery Period for Vertebroplasty?

Vertebroplasty is a minimally invasive procedure, and patients can go home on the same day of the procedure. The soreness may go away within a few days, and can also take some pain medicine for a couple of days. Moreover, the people will return to their daily activities within a few weeks of the procedure.


Who Is a Candidate for Vertebroplasty?

Vertebroplasty is most commonly performed for an injury like a compression fracture. Because of fractures, people with this condition cannot move and do daily activities. This is most commonly seen in older people with serious bone disorders like osteoporosis, which weakens bones.


Can Vertebroplasty Get Damaged?

Vertebroplasty is usually a safe procedure and does not cause any serious complications. However, some might also occur, including. 
- Leakage of cement could increase pain or tingling sensations. However, this is rarely seen.  
- Paralysis due to incorrect needle placement might damage the nerves or spinal cord.


What Are the Drawbacks of Bone Cement?

Bone cement has many advantages but also has some disadvantages, which may include 
- High polymerization temperature.
- Cement shrinkage.
- Exudation of toxic monomers.
- The porosity of polymeric materials.


Is Bone Cement Stronger Than Bone?

Human bones are considered very strong. Bones are found to be four times stronger than concrete. However, the bone cement used in various procedures is very strong compared to human bones. The bone cement has a shear strength of around 40 MPa (MegaPascal), and that of human bone is 3 to 10 MPa.


Does Vertebroplasty Increase Height?

The vertebroplasty procedure is most commonly done in patients with osteoporosis or vertebral compression fractures. This procedure helps relieve pain with a very conservative method. Moreover, restoration of vertebral body height is another advantage, and according to various studies, it has also helped restore height.

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Last reviewed at:
27 Jul 2023  -  5 min read




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