Radiology - A Guide to your Vertebroplasty

What is a vertebroplasty and why do I need one?

A vertebroplasty is a procedure during which a special needle is passed through the skin into one or more vertebral bodies before cement is injected. Occasionally this can be used in other bones not just the spine.

The Radiologist (specially trained doctor) will use x-rays to guide the needle into the bone in question.

There are various reasons for performing this procedure.

These include:

Helping treat pain from a diseased or fractured vertebra.Helping to prevent fracture of a soft or diseased vertebra. Treating/preventing enlargement of some types of bone lesions.

Your consultant and the radiologist who will be performing the vertebroplasty have discussed your case and feel that this is the best treatment option. You will have had the opportunity to discuss this treatment with your doctor. The radiologist will also be able to answer any questions you have. After the discussion with your doctor, if you do not want the procedure to be carried out you can decide against it.

Who will do the vertebroplasty?

An interventional radiologist who is a specially trained doctor will perform the procedure.

Interventional radiologists have special expertise in using x-ray equipment to do a vertebroplasty as well as interpreting the images produced. They will need to look at the images while carrying out the procedure. At times this procedure is done under a general anaesthetic. If performed under a general anaesthetic then you will need to have a pre-op appointment. You will also be able to discuss this with a member of the anaesthetic team before the procedure.

Where will the procedure take place?

Generally in the x-ray department in a special “screening” room. This is an x-ray room designed for specialised procedures.

What preparation is there for a vertebroplasty?

You need to be admitted to hospital for the procedure. You will be asked to fast for up to 6 hours before your procedure where you must not eat, you will be allowed to take some sips of water up to 2 hours before your procedure. You will be asked to change into a hospital gown.

If you are taking any anticoagulants (blood thinners) i.e Warfarin, Clopidogrel, Aspirin please contact your doctor as these medications may need to be stopped several days prior to the procedure.

Please take all other medication as normal.

If you have any allergies, you must let the doctor on the ward know.

What are the risks and complications?

A vertebroplasty is a safe procedure and serious complications are rare. Small risks very depending on where in the body the vertebroplasty is performed. Despite these small risks your consultant has decided to refer you for this procedure.

This is because they feel that the benefits of having the vertebroplasty outweigh the risks of having it done. The risks include the following:

Discomfort or mild pain in the area where the vertebroplasty is performed. This can usually be controlled with painkillers.Bleeding is usually minimal and of short duration but more serious bleeding can rarely occur. Of the bleeding continues, then it is possible that you might need a blood transfusion. Very rarely, an operation or another procedure is required to stop the bleeding. Infection of the skin or deeper tissue is rare. Injury of surrounding structures, either by the needle or the injected cement. These depend on where the vertebroplasty is performed but are very rare. These include compression of the neural structures by cement (spinal cord or nerves to your legs), cement travelling to and damaging your lungs and damage to the surrounding structures by the needle.

If you have any worries, please do not hesitate to discuss possible complications or risks with hospital staff before your vertebroplasty.

What actually happens during a vertebroplasty?

You will be brought to the x-ray department to have your vertebroplasty. The radiologist (the doctor who will do your procedure) will speak to you beforehand and answer your questions. Please let them know if you are allergic to anything. The skin over the procedure site will be cleaned with an aseptic and covered with a sterile drape.
 
The procedure will be performed under either a local or general anaesthetic. The local anaesthetic will sting initially, before the skin goes numb. You will also likely have some sedation and pain killers also administered by an anaesthetist. The doctor will use x- rays to guide the needle to the vertebral body/bone. You will need to stay still. You may feel some discomfort during the procedure.

The procedure time depends how many vertebras are being treated and the complexity of the case. It usually takes at least 1 hour but can take up to about 3 hours.

After the Vertebroplasty

You may be taken back to the ward where you need to rest in bed for a few hours. The nurses will check your blood pressure and pulse regularly to make sure that there are no problems. Some patients may experience pain following this procedure. Please let the nurses know if you pain or if you need any painkillers.

You can eat and drink as normal unless instructed otherwise by the doctor.

Going home

If the procedure is being carried out as a day case and there are no complications, you will be allowed home a few hours after the procedure. You must not drive or use public transport. You must have an adult to take you home (by car or taxi) and stay with you overnight.
 
If you live a long distance from the hospital or there is no one to take you home or stay with you overnight, you will have to stay in hospital.

If you feel unwell or continue to have severe pain you should seek immediate medical advice (contact your GP or your consultant; or go to your nearest Accident and Emergency department).

Could you be pregnant?

If there is any chance you could be pregnant, please call 0161 2065091 if your appointment is at Salford Royal Hospital. Please call 0161 656 1178 if your appointment is at Royal Oldham Hospital.

Is x-ray guidance dangerous?

All x-ray machines use potentially harmful x-rays. Modern equipment is designed to keep the dose you receive as low as possible. If your doctor has asked for this test, they will have decided that the benefits from the procedure outweigh the risks from the very small dose of radiation that you receive.

What if I cannot attend my appointment?

If you have any queries about your appointment or cannot attend, then please telephone the booking office on:
0161 204 2044 or 2404 (Salford Royal Hospital)
0161 624 0420 (Royal Oldham Hospital) Monday to Friday 8.30am to 4.00pm.

You can also email:
salford.radiology.booking@nca.nhs.uk (Salford Royal Hospital).
bookingandscheduling.outpatients@nca.nhs.uk (Royal Oldham Hospital)

Please include name, date of birth, address and hospital number (if known) in any correspondence.

I need an ambulance. How do I arrange one?

If you need an ambulance there are contact details on your appointment letter.

Please contact us if you are arriving by ambulance so we can time your appointment with your ambulance arrival. If we are not aware that you are coming by ambulance you may miss your appointment and it may have to be rebooked.

If you need an interpreter

If you need an interpreter for your examination, please call the department so that we can try and arrange this.

Contact Details

We hope your questions have been answered by this leaflet.

If you require help or any other information regarding your appointment you can contact:
The Angiography Department, Salford Royal Hospital. Tel: 0161 206 2206/5091
Interventional Radiology, Royal Oldham Hospital. Tel: 0161 656 1178