Vertebroplasty — Procedure Guide, Recovery & Risks | MyMedicPlus

Vertebroplasty is a minimally invasive percutaneous procedure in which polymethylmethacrylate (PMMA) bone cement is injected under imaging guidance into a fractured vertebral body to stabilise the fracture and relieve pain, without restoring vertebral height.

Indicated for painful osteoporotic vertebral compression fractures (VCFs) that are acutely symptomatic and unresponsive to 4–6 weeks of conservative management (analgesia, bed rest, bracing). Also used for pathological vertebral fractures from spinal metastases or myeloma.

Under fluoroscopic or CT guidance with local anaesthesia and intravenous sedation, a transpedicular trocar (11–13 gauge needle) is advanced bilaterally into the fractured vertebral body. Liquid PMMA cement is injected slowly under continuous real-time imaging to fill the fracture cleft.

Patients are observed for 2–4 hours post-procedure and may mobilise the same day. Pain relief typically occurs within 24–48 hours as cement polymerises and stabilises the fracture. Normal daily activities resume within a few days; heavy lifting and high-impact activities are avoided for 6 weeks.

Cement leakage occurs in 10–40% of cases on imaging but is clinically significant in less than 1% — most leaks are small and asymptomatic. Serious risks include cement embolism, spinal canal leakage causing neurological deficit, infection, and rib fractures from needle placement.

Approximately 85–90% of carefully selected patients report clinically significant pain reduction within 48–72 hours. Effectiveness is broadly equivalent to balloon kyphoplasty. Vertebroplasty does not restore vertebral height but provides reliable pain relief enabling mobilisation and reduced opioid dependency.