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Surgical procedures for vertebral fractures
Two surgical procedures may be used to treat vertebral compression fractures that don't respond to bedrest, pain medication, and bracing:
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Vertebroplasty is a procedure to reinforce a collapsing vertebral body using a special cementlike material. With the patient lying on his or her stomach, the doctor inserts a hollow needle, called a trocar, through the skin and into the vertebra. A type of X-ray, called fluoroscopy, is used to guide the needle into position. A contrast agent (dye) is injected to help the doctor see and avoid blood vessels.
Once the needle is in place, a syringe is inserted to inject the cement mixture into the bone. As the cement hardens, it permanently reinforces the weakened vertebra. The procedure is usually done on both the right and left sides of the fractured vertebral body. Vertebroplasty can relieve the pain and prevent further collapse of the vertebral body. It cannot correct the spinal curve but may help prevent progression of the curvature.
Kyphoplasty is similar to vertebroplasty in that it uses a type of bone cement to reinforce the vertebral body. During kyphoplasty, however, an inflatable balloonlike device is inserted into the vertebra through the bone needle. As the balloon is inflated, it opens up a space that is then filled with the bone cement. In addition to stabilizing the vertebra and relieving pain, kyphoplasty restores the height of the vertebra, thereby correcting some of the spinal curve.
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