Skip to main content

Common Questions

Listed below are frequently asked questions relating to the Vertebroplasty procedure. If you are looking for additional information, please use our information request form or contact your physician.

What is vertebroplasty?

Percutaneous vertebroplasty is a minimally invasive, typically outpatient procedure used to treat vertebral compression fractures caused by painful osteoporosis and metastatic tumors. Individual vertebra weakened by disease can collapse suddenly under the force of normal, daily activity; the resulting intense pain causes limited mobility and other significant reductions in quality of life.

During vertebroplasty, the collapsed vertebra is stabilized with specially formulated acrylic bone cement; in addition to providing pain reduction, vertebroplasty can prevent further collapse of the vertebra, height loss and spine curvature. (1)

Who should have vertebroplasty?

People with persistent back pain caused by vertebral compression fractures are potential candidates for vertebroplasty. Common causes of these fractures are osteoporosis and bone tumors. Patients taking high doses of steroids for the control of diseases such as lupus, scleroderma, asthma or chronic obstructive pulmonary disease might also be candidates. Consult your primary care physician or a qualified vertebroplasty practitioner to determine whether you are a candidate for the procedure.

How can vertebroplasty help me?

In most patients, vertebroplasty provides immediate improvement in pain related to vertebral compression fractures. Many patients return to their normal activities within only a few days of having the procedure, and most report continued pain reduction months and years later.

What is involved in vertebroplasty?

The procedure is outpatient based and typically performed in the radiology suite, where the patient lies face down on a table. A local anesthetic is used to numb the affected area of the patient's spine, where the physician inserts one or two needles through a small incision in the patient's skin. Under x-ray guidance, the physician inserts the needles into the fractured vertebra and slowly injects a small amount (~1/4 ounce) of bone cement into the vertebra. The bone cement hardens quickly. The patient is kept for observation for a few hours following the procedure. In rare cases, the patient is kept overnight for observation. Review how this procedure works.

How long does vertebroplasty take?

Patients typically spend 1 to 2 hours in the radiology suite for treatment of a single vertebra. Each vertebra takes about half an hour, so treatment of multiple vertebral fractures takes longer. Patients typically spend two to three hours following the procedure in a comfortable observation area to be sure there are no complications or side effects.

What is the success rate, and what are the risks?

Most patients report significant pain reduction within a few hours of the procedure. Studies report over 90%(2) and higher success rates for significantly relieving pain associated with vertebral compression fractures. Patients are able to return to their normal activities within a few days. Complications from the procedure are rare, affecting only about 1-3% of patients with osteoporotic compression fractures. (3)

The success rate and potential complications depend upon each patient's health and other factors. You should discuss these risks and complications with your doctor.

What are the long-term effects of bone cement?

The acrylic cement used in vertebroplasty is similar in formulation to the materials used extensively in orthopedic surgery (to anchor the components of hip and knee replacements to healthy bone) since the 1960s and is considered to be a lifetime implant. There are no known detrimental long-term effects. (4)

What cement is used?

Various polymethylmethacrylate cements have been used; however most physicians utilize a cement indicated for craniofacial defect repair mixed with commercially available Barium Sulfate to approximately a 30% barium mixture by weight. Adequate opacification must be achieved in order to perform the procedure safely.

What are the long-term effects of bone cement in the spine?

Polymethylmethacrylate has been used for over four decades as an orthopedic cement and the side effects have been studied. The strength of the bone cement and durability would be expected to outlast the native bone in elderly, osteoporotic patients. The long-term effects of bone cement in percutaneous vertebroplasty have been covered in numerous peer-reviewed journal articles. Refer to the Research Articles for more information.

What published clinical outcome studies would you recommend?

Hundreds of scientific papers have been published on vertebroplasty and can be located via Medline. The results of these studies suggest a remarkable benefit over conservative therapy. Long-term studies also need to be performed to rule out the possibility of any long-term sequelae. Refer to the Research Articles for links to recent peer reviewed articles and other resources.

Is vertebroplasty covered by Medicare or private insurance?

Percutaneous Vertebroplasty is a covered service for Medicare beneficiaries in many states when medically necessary. CMS continuously reviews its coverage policy for Percutaneous Vertebroplasty based on advances in the technology, as well as evidence available on medical effectiveness for selected indications. To confirm coverage policy inclusions and restrictions, consult Medicare national coverage determinations and/or your local Medicare contractor.

Private insurance health plan members may be eligible under plan guidelines for Percutaneous Vertebroplasty.  Check with the individual payer to determine conditions for medical necessity, specific contraindications to the procedure and coverage details.

How can I find a doctor skilled in vertebroplasty?

Visit Locate a Doctor to search for doctors in your area who specialize in vertebroplasty.


Back to top


Notes

(1) J. Kevin McGraw, et al., Prospective Evaluation of Pain Relief in 100 Patients Undergoing Percutaneous Vertebroplasty Results and Follow-up, JVIR 2002: 13:883-886.

(2) Complication rates associated with other conditions, such as hemangiomas and metastatic bone tumors, may be as high as 10%.

(3) There have been reports of implant loosening associated with cement particulates generated by implant wear.