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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
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