VCF Procedures

Vertebra compression fracture (VCF) is one common condition of spinal diseases; there are approximately 700,000 clinically-diagnosed spine fractures each year due to osteoporosis in the United States and Europe in approximately 550,000 patients, 150,000 fractures every year in 50,000 patients due to cancer, and 100,000 patients per year in United States and Europe owing to traumatic vertebral compression fractures. About half of all vertebral fractures occur silently, without any significant pain. Others can be very painful and disabling. The majority of these fractures, even though they are painful at the beginning, heal on their own with little or no remaining pain or disability.

There are three standard treatments for a vertebra fracture: pain medication, progressive activity, and the use of brace for support. Even after the fracture was healed, there remains a high risk of a new fracture. Osteoporosis usually is a key factor of this new fracture, hence, evaluation and treatment of it is very important to minimize this risk.

There are two types of minimal invasive procedures which can relieve the pain of a vertebral fracture. These procedures, Vertebroplasty and Kyphoplasty, are most commonly used in cases of server pain caused by vertebral fractures that does not improve over a number of weeks with those standard treatments. Both Vertebroplasty and Kyphoplasty procedures place cement into the fractured vertebra through minimal invasive surgery.

In Vertebroplasty
- Inject bone cement directly into the fractured vertebra.
- After injected, the cement hardens in about 10 minutes, congeals the fragments of the fractured vertebra, and provides immediate stability.

In Kyphonplasty
- Guide a balloon catheter into the fractured vertebra and inflate it with a liquid under pressure.
- As the balloon is inflated, it can help to restore the collapse in the vertebra and can correct abnormal wedging of the broken vertebra.
- Deflate and remove the balloon after it is maximally inflated, and fill with bone cement in the cavity.
- The cement then hardens in place and maintain the correction of collapse and wedging.

Both techniques are successful about 90% of relieving the pain of fractured vertebrae. There are, however, some potential server risks and complications


Potential Risks and Complications of Vertebroplasty and Kyphoplasty
There are some significant risks in these cement injection procedures (some typical and serious risks are as bellow) , hence, patients and doctors should make careful decisions when they consider whether to take these procedures.

- Along with injection and before final hardening, leakage of cement out of the vertebra is the most common complication.
- If the cement leaks back into the spinal canal, it can compress the spinal cord and nerves, and then cause new pain and neurological problems.
- There are a few cases of pulmonary embolism of the lungs and even death associated with these procedures.

Before Kyphoplasty and Vertebroplasty were available the gold standard for a compression fracture was west, time and medications. Compression fractures have a high rate of success in terms of healing although it may take a while (about three months). Generally, most clinicians will wait to see if the fracture will heal on its own, although it may need about three months to heal. If the patient, however, is in so much pain that he or she cannot function, Kyphoplasty or Vertebroplasty surgery may be considered sooner.

Vesselplasty procedure overcomes these potential risks and complications caused by Vertebroplasty and kyphonplasty procedures, making it possible to adopt active surgeries to relieve continuous and unlimited pain caused by vertebral fractures.


Reference:
- Darwono, A. B., “Vesselplasty as an Alternative to Kyphoplasty,” APOA Kuala Lumpur September 5-10, 2004.
- Jerrrey M. Spivak, “Vertebroplasty and Kyphoplasty: Percutaneous Injection Procedures for Vertebral Fractures,” Spine-health.com