Minimally Invasive Procedures

Vertebral body augmentation

Vertebral augmentation is performed to treat painful vertebral compression fractures. These fractures are procedure unless a patient has failed 4 weeks of conservative therapy and can walk, or has failed 2 weeks of conservative therapy and can’t walk.There are several types of vertebral augmentation procedures. They all involve placing a small metal tube, or cannula, through a small skin incision and through the bone of the vertebra to the region of the fracture. In the kyphoplasty procedure, a balloon is placed into the vertebrae and inflated. The resultant cavity is then filled with cement. In another form of augmentation, a hole is created in the fractured vertebra. A mesh bag is inserted through the cannula into the hole and the bag is filled with bone, creating a fusion of the fractured vertebrae. Finally, augmentation can be performed by applying energy to the cement as it is injected into the fractured vertebrae. This creates more viscous, thick cement and may confer similar benefit as kyphoplasty without the use of a balloon to create a cavity in the fractured vertebrae.

Whatever the exact method used, the mechanism of improvement is similar. The introduction of cement stabilizes the fracture by “casting” it from the inside. With stabilization, the patient can move and sit with drastically reduced pain. In addition, the cement heats as it hardens. It’s possible that as the cement heats, painful nerve endings in the fractured vertebra are burned, causing an anesthetic effect.