vertebroplasty Flashcards
Vertebroplasty is performed to treat what condition?
Vertebroplasty is performed to treat compression fractures of
the vertebrae.
Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Stock MC,
Ortega R. Clinical Anesthesia. 7th ed. Philadelphia, PA:
Lippincott Williams and Wilkins; 2013: 1664.
How is a vertebroplasty performed?
The patient is placed in the prone position and the back is
prepped and draped. A fluoroscope is mandatory for the
procedure so that the surgeon or radiologist can guide the
trocars and monitor the cement injection. The vertebral body is
entered via a posterior approach through the pedicle.
National Osteoporosis Foundation. Percutaneous
Vertebroplasty. [Online] June 20, 2008
.
How does kyphoplasty differ from vertebroplasty?
Vertebroplasty involves the injection of cement directly into the
vertebral body. During a kyphoplasty, a balloon is inflated
inside the vertebral body prior to injection of a more viscous
cement than that used for vertebroplasty.
Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Stock MC,
Ortega R. Clinical Anesthesia. 7th ed. Philadelphia, PA:
Lippincott Williams and Wilkins; 2013: 1664.
What are the pulmonary sequelae of symptomatic
vertebral compression fractures?
Patients with symptomatic vertebral compression fractures
suffer from a loss of vertebral height. As the vertebral column
shortens, kyphosis and limited mobility result, which can lead to
atelectasis, pneumonia, and deep vein thrombosis.
Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Stock MC,
Ortega R. Clinical Anesthesia. 7th ed. Philadelphia, PA:
Lippincott Williams and Wilkins; 2013: 1664.
What class of patients typically undergo vertebroplasty?
Because vertebral compression fractures often occur as a result
of osteoporosis, the elderly are the most likely group to undergo
vertebroplasty.
Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Stock MC,
Ortega R. Clinical Anesthesia. 7th ed. Philadelphia, PA:
Lippincott Williams and Wilkins; 2013: 1664.
What are the potential neurologic complications of
vertebroplasty?
Radiculopathy, spinal claudication, and paraplegia are potential
neurologic complications of vertebroplasty.
Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Stock MC,
Ortega R. Clinical Anesthesia. 7th ed. Philadelphia, PA:
Lippincott Williams and Wilkins; 2013: 1664.
Which is more likely to result in extravasation of
cement, kyphoplasty or vertebroplasty?
Vertebroplasty is more likely to result in extravasation of the
cement because the cement used in vertebroplasty is less
viscous than that used for kyphoplasty.
Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Stock MC,
Ortega R. Clinical Anesthesia. 7th ed. Philadelphia, PA:
Lippincott Williams and Wilkins; 2013: 1664.
How is the patient positioned during and after a
vertebroplasty?
The patient is positioned prone for the actual procedure and
should remain supine for 3-5 hours after the procedure for
evaluation of neurologic status and careful observation for
bleeding.
Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Stock MC,
Ortega R. Clinical Anesthesia. 7th ed. Philadelphia, PA:
Lippincott Williams and Wilkins; 2013: 1664.
What type of cement is injected into the vertebra
during a vertebroplasty? How much cement is
typically injected?
2-6 mL of polymethyl methacrylate is injected into the vertebral
body during a vertebroplasty.
Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Stock MC,
Ortega R. Clinical Anesthesia. 7th ed. Philadelphia, PA:
Lippincott Williams and Wilkins; 2013: 1664.
What forms of anesthesia are acceptable for
vertebroplasty?
General anesthesia and IV sedation are both acceptable
techniques when performing a vertebroplasty.
National Osteoporosis Foundation. Percutaneous
Vertebroplasty. [Online] June 20, 2008
.
