Meet Larry, Tucson senior
Larry had lost his zest for life. Normally very happy and active, he was nearly homebound. The pain in his back had become so severe that even routine tasks like driving and walking were impossible. He spoke to his physician, who recommended that Larry meet with the Interventional Radiologist at Radiology Ltd. to discuss vertebroplasty. Immediately after the Verterbroplasty procedure in Tucson, Larry felt pain relief and was able to resume driving and walking within a few days. “Vertebroplasty and the radiologists at Radiology Ltd. changed my life. I am forever grateful.”
VBA is an image-guided procedure used to treat painful vertebral body fractures in the thoracic and lumbar spine. Most of the time, the cause of fracture is osteoporosis but there are other causes such as tumor or trauma.
The diagnosis is usually made by X-ray but most patients will need an MR scan to date the fracture and provide necessary anatomical information. Alternatively, CT and nuclear bone scans will be needed.
A needle will be inserted into the vertebral body under X-ray guidance. If vertebroplasty is performed, a small amount of cement will be injected under fluoroscopic guidance, following the fracture lines, securing the fracture. Kyphoplasty is a procedure which involves creation of a cavity inside the vertebral body and injecting cement which is especially formulated to stay within the cavity. Both procedures are effective in reducing the pain associated with compression fractures. The decision which procedure to be used will be made by the interventional radiologist.
You will be asked not to eat after midnight the night before the procedure. You may have clear liquids up to 2 hours before the procedure but should not drink anything after that.
If you are taking prescribed anticoagulants (blood thinners) such as Coumadin or Plavix, you should ask your physician for instructions prior to the procedure. Patients should not take over-the-counter aspirin or aspirin-containing medications for at least 5 days prior to their procedure. Please consult with your doctor or healthcare provider before stopping ANY medications.
Please arrive for your procedure with a responsible adult who can drive you home.
Prior to your procedure, you will have a thorough consultation with our Interventional Radiology nurse practitioner and one of our Interventional Radiologists. All possible treatment options will be reviewed and discussed with you in detail, and all of your questions will be answered.
After you arrive for your appointment, you will be escorted to a procedure room, where you will be asked to change into a patient gown. You will have an intravenous (IV) line placed in your arm so that pain medication and sedatives can be administered prior to and during your procedure. You will be positioned on an exam table, and fluoroscopy will be used to determine the most appropriate needle entry site. The radiologist will cleanse the overlying skin, and a small amount of local anesthetic (lidocaine) will be injected with a small needle. You will feel a tiny pinch similar to a pinprick while the anesthetic is injected.
After the area becomes numb, the radiologist will insert one or two needles into the fractured vertebral body while observing under fluoroscopy. A small amount of contrast material may be injected to confirm the proper needle position. A cavity may be created to deposit the cement. Bone cement mixed with a small amount of inert barium will then be injected through the needle into the fractured vertebral body. Once a sufficient amount of bone cement has been placed, the needles will be removed, and bandages will be placed over the insertion sites. You will remain on your stomach for about ten minutes while the cement begins to harden. You will then turn over and lie on your back for up to two hours while the cement continues to strengthen. You will then be discharged and will be given instructions and phone numbers of whom to call if you have any problems.
The contrast agent that is used during the procedure is an iodine-based material. Radiology Ltd. uses only non-ionic contrast agents (the safest kind), but with all contrast agents there is always the potential for allergic reaction. Be sure to tell your technologist if you have experienced a reaction to CT contrast in the past. If you are diabetic and take Glucophage, Glucovance, or any other type of metformin medication to regulate your diabetes, you will need to stop taking it for 48 hours after your exam.
For your safety and the protection of others, we do not allow anybody except patients in our exam rooms.
Significant complications related to VBA are very uncommon. The primary risks associated with this procedure include:
- Allergic reaction to the contrast material
- Cement leakage affecting adjacent neural structures
Most VBA procedures are very well tolerated. You may apply ice to the needle insertion site to reduce swelling if necessary. Symptoms usually disappear within 48 hours; contact your physician or healthcare provider if they persist for more than two days.