Fracture Vertebra Treated with Percutaneous Vertebroplasty

Case Presentation

I saw 2 patients with similar complaints of severe agonizing pain in the back. They had history of cancer of prostate, operated, taken Chemotherapy few cycles and were doing well. One fine day suddenly pain in back started and it became unbearable. MRI showed pathological fracture with bone marrow edema. One patient had fracture at L2 and other one had this at L4 vertebra.

We advised them Vertebroplasty as immediate treatment to stabilise their spine, avoid further reduction in height of vertebra and for instant pain relief. They agreed for the procedure.

The Vertebroplasty Procedure

This procedure involves inserting a needle under local anesthesia through the vertebral bone under live C-arm (X-ray) guidance and then injecting medical cement in the front fractured portion of the vertebra. This took approximately 30-40 minutes.

Outcome

Post-operatively they were 90% pain free with free movement in the bed. Their happiness after the procedure was gratifying and gave me a sense of satisfaction.

The key was the decision taken by them was quick and we didn't lose much time. It is possible that the fractured vertebra's height might reduce over days and this procedure is not possible after certain degree of height reduction.

In conclusion, good patient-doctor coordination and early treatment helps in better outcome.