What Is a Palatoplasty?

Vertebroplasty is called percutaneous vertebro plasty (PVP). It is a minimally invasive surgery. It is achieved by injecting bone cement (polymethylacrylate, PMMA) or artificial bone into the diseased vertebra. Techniques to strengthen the vertebral body.

Basic Information

Chinese name: Vertebroplasty
Foreign name: Vertebroplasty

Related diseases: Vertebral fracture
Specialty classification: orthopedics

Vertebroplasty types and methods

PVP began in the early 1980s, and balloon dilated kyphoplasty (PKP) began in the late 1990s. The latter appeared more than 10 years later and was improved based on lessons learned from PVP.

1.PVP

By making an incision of about 2mm on the patient's back, a special puncture needle is used to penetrate the vertebral body through the skin under X-ray monitoring, establish a working channel, and inject bone cement or artificial bone into the vertebral body to stabilize the fractured vertebral body and prevent further collapse. , Obviously relieve pain.

2.PKP

After the balloon expansion, the bone cement is injected several times. On the one hand, the cancellous bone around the cavity left after the balloon expansion is compacted, artificially creating a barrier to prevent bone cement leakage; on the other hand, a push rod is used. Compared with traditional pressure pumps, continuous injection of bone cement in fractional injection greatly reduces the pressure when bone cement is injected, so the leakage of bone cement is greatly reduced.

Vertebroplasty advantages

Analgesic

Both balloon-expanded PKP and traditional PVP have a reliable and effective analgesic effect. The pain relief rate reported in the literature is 70% to 95%. It can also prevent further compression and collapse of the fractured vertebral body. For fracture reduction and correction of kyphosis, balloon dilation PKP is superior to traditional PVP. Some scholars have reported that PVP's immediate analgesic effectiveness can reach 97%, the pain score drops from severe pain to mild pain, and the overall satisfaction rate of patients is above 80%. Clinical experience also confirms that PVP has quite amazing early analgesic effects. It can be said that no effective drug treatment can obtain such effective analgesic effects.

2. Reduce complications

The operation time of PVP is about 30 minutes. After 24 hours, the patient can return to normal life under the protection of external fixation, reducing the incidence of bed-related complications of fractures. Due to the patient's early activities, complications such as pneumonia, pressure ulcers, and urinary tract infections caused by long-term bedridden and inconvenience in nursing are avoided, and a vicious cycle of osteoporosis caused by long-term bedridden bone loss is avoided. In the later stage, it can also prevent symptoms such as back pain caused by vertebral compression and kyphosis, bloating discomfort and even difficulty of standing upright.

3. Other

It has been reported that the bone cement leakage rate of ball PKP is about 10%. PKP can restore the height of the vertebral body and maintain the physiological curvature of the patient's spine by inserting special tools (balloons, etc.) into the vertebral body. Some scholars have compared the effects of PKP and PVP in restoring vertebral height through in vitro experiments. As a result, the balloon can recover 97% of the lost height, while traditional PVP can only recover 30%.

Reducing the leakage rate is equivalent to reducing the complications of the operation, and restoring the vertebral height, improving the kyphosis, and maintaining the normal sequence of the spine are beneficial to prevent the occurrence of back pain in the future.

Vertebroplasty analgesic mechanism

The mechanism of PVP relief pain may be the anchoring of bone cement in the fractured vertebral body, which fixes the microfractures in the osteoporotic vertebral body, increases the stability of the vertebral body, and reduces the stimulation of the painful nerve endings in the vertebral body In addition, it is possible that the exothermic and toxic effects of the polymerization of bone cement destroy nerve endings and inflammatory pain factors in the vertebral body, change the microenvironment in the vertebral body, reduce pain sensitivity, and block the production of pain mediators. Achieve analgesic effect.