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Vertebroplasty and kyphoplasty in Tijuana — Dr. Carlos A. Noreña Osterroth
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Vertebroplasty and kyphoplasty in Tijuana

An osteoporotic vertebral fracture that will not settle. Bone cement is injected percutaneously into the vertebral body to stabilise it and relieve the pain.

A fracture that happens without a fall

In an osteoporotic spine a vertebral body can collapse with minimal effort: lifting a bag, a hard sneeze, sitting down abruptly. The patient describes intense, very localised back pain that worsens on rising from a bed or chair and eases when lying down.

Most of these fractures are managed conservatively: analgesia, a brace, early mobilisation and, above all, treatment of the underlying osteoporosis, which is the real disease. When the pain does not settle within a few weeks, or prevents standing, vertebroplasty enters as an option.

How it is done and what to expect

It is a percutaneous procedure: under fluoroscopic control a large-bore needle is passed through the pedicle into the fractured vertebral body and bone cement is injected, hardening within minutes and stabilising the fracture. Kyphoplasty adds a balloon inflated beforehand to create a cavity and attempt to restore some vertebral height.

There is no open incision, it is done under sedation or local anaesthesia, and most patients mobilise the same day. What must not be forgotten: the procedure treats the fracture, not the osteoporosis. If the bone is not treated, new fractures will appear at other levels.

What the procedure involves

Confirmation of an acute fractureMRI with STIR sequence to distinguish a recent fracture from an old consolidated one.
Percutaneous transpedicular accessNeedle through the pedicle under fluoroscopy, with no open incision or muscle dissection.
Controlled cement injectionVolume and rate watched in real time to avoid cement leak into the canal.
Balloon kyphoplastyA cavity is created so cement can be delivered at lower pressure and height partly restored.
Osteoporosis treatmentReferral for densitometry and antiresorptive therapy: without it, more fractures follow.

When it is indicated

  • Painful osteoporotic vertebral fracture unresponsive to conservative care
  • Acute vertebral fracture confirmed on MRI with bone oedema
  • Pathological fracture from metastasis or myeloma without canal compression
  • Disabling pain preventing standing in an older adult
  • Progressive vertebral collapse on serial imaging
  • Vertebral fracture in a patient unfit for open surgery

Techniques and resources

  • Bone cement (PMMA)
  • Transpedicular needles
  • Kyphoplasty balloon
  • High-resolution fluoroscopy
  • MRI with STIR sequence
  • Bone densitometry

Frequently asked questions about vertebroplasty and kyphoplasty

It is performed under sedation or local anaesthesia and is usually well tolerated. What most strikes patients is how quickly the fracture pain settles over the first days when the procedure is properly indicated.

Yes, if the osteoporosis is not treated. That is why vertebroplasty must never be the only treatment: bone density needs studying, vitamin D and calcium correcting, and specific therapy starting. Cement fixes one vertebra; treatment protects the rest.

No. Most consolidate with conservative management within four to eight weeks. The procedure is reserved for pain that does not settle, pain that prevents standing, or selected pathological fractures.

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