I am frequently asked by patients and their families which procedure is best to fix vertebral compression fractures (VCFs). There are numerous procedures available, and the choices can be confusing. The good news is that almost all of these choices are 'medical miracles' that have success rates near 100% for pain relief. In experienced hands, any of these proven procedures can be a 'magic bullet' for VCF pain.
In general, these can be divided into vertebroplasty and vertebral body augmentation (VBA). Simple vertebroplasty is highly effective, however involves only placing a needle into the fractured vertebral body and injecting bone cement (PMMA).
Vertebral augmentation (VBA) goes a step further by creating a cavity in the body prior to stabilizing the fracture. This is usually done to try to 'lift' the fracture back into place, but can have other effects. One reason I prefer to use VBA is because it creates a cavity and disrupts the plexus of blood vessels in the vertebral body. As a result, this decreases the likelihood of cement leakage so that patients have better outcomes.
Although the most common form of VBA is known as kyphoplasty, there are several other procedures that accomplish the same thing (see below).
Common procedures to fix VCFs
· Vertebroplasty: Simply involves putting a needle into the fractured vertebral body and injecting bone cement (PMMA).
· AVA Flex: Uses an advanced flexible needle to create a cavity and deliver targeted bone cement.
· Balloon VBA (‘Kyphoplasty”): Uses a balloon to create a cavity and then deliver targeted bone cement.
· Allograft Bone VBA (“Spinoplasty”): Uses allograft bone in an implant to stabilize the fracture like a sandbag.
· Sacroplasty: Vertebroplasty technology is applied to fix painful fractures of the sacrum.
· Osteoplasty: Relieves pain from chronic and atypical fractures using the same technology as vertebroplasty.
There are many different factors that affect which procedure is best for your situation. Discussing this with your doctor is essential to make the best decision.