22510 Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; cervicothoracic

Name of the Procedure:

Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; cervicothoracic.

Summary

Percutaneous vertebroplasty is a minimally invasive procedure to treat vertebral compression fractures. It involves injecting bone cement into a fractured vertebra to stabilize it and reduce pain. This can be done using imaging guidance to ensure accuracy, and it may also include a bone biopsy if needed. The procedure can be performed on either the cervical (neck) or thoracic (upper back) regions of the spine.

Purpose

This procedure aims to:

• Relieve pain caused by vertebral compression fractures.
• Stabilize the fractured vertebra.
• Improve the patient's ability to move and perform daily activities.

Indications

• Painful vertebral compression fractures due to osteoporosis, tumors, or trauma.
• Patients who have not responded to conservative treatments like bed rest, pain medication, or bracing.
• Patients with a vertebral fracture confirmed via imaging studies like X-rays, MRI, or CT scans.

Preparation

• Patients may need to fast for a few hours before the procedure.
• Blood tests and imaging studies may be conducted to confirm the diagnosis and plan the treatment.
• Medications, especially blood thinners, may need to be adjusted as per the doctor's instructions.

Procedure Description

1. The patient lies face down on the procedure table.
2. Local anesthesia and sedation are administered to ensure comfort.
3. Using fluoroscopic (X-ray) or CT guidance, a needle is inserted into the fractured vertebra.
4. Bone cement is injected through the needle into the vertebra.
5. If necessary, a bone biopsy might be taken.
6. The cement hardens, stabilizing the fracture.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

It is usually performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Interventional radiologist or orthopedic spine surgeon.
• Radiologic technologists and nurses.
• Anesthesiologist or nurse anesthetist.

Risks and Complications

• Common: Minor bleeding, soreness at the injection site.
• Rare: Infection, cement leakage, nerve damage, allergic reaction to anesthesia.

Benefits

• Significant pain relief typically within 48 hours.
• Improved mobility and quality of life.
• Reduced need for pain medication.

Recovery

• Patients are usually monitored for a few hours post-procedure.
• Most can go home the same day.
• Instructions include limited physical activity for a short period.
• Follow-up appointments to monitor recovery and assess the effectiveness.

Alternatives

• Conservative treatments (e.g., pain medication, physical therapy).
• Surgical options like spinal fusion.
• Pros: Less invasive and quicker recovery for vertebroplasty.
• Cons: Possible need for repeat procedures; surgery might offer a more permanent solution.

Patient Experience

• During the procedure, patients might feel slight pressure or discomfort.
• Post-procedure, they may feel soreness at the injection site, which typically subsides in a few days.
• Pain relief can be significant and rapid, with most experiencing improved function and reduced pain.