Treatment: Vertebroplasty: Post-Op

Following the procedure, the patient is instructed to lie flat in the supine position for one hour to allow the cement to harden. Observation is continued for at least one to two hours, at which point most patients will be able to stand and walk with minimal or no pain. Some patients may require non-steroidal anti-inflammatory drugs (NSAIDs) for procedure-related discomfort. When the patient is stable, another adult may drive them home.

Pain relief is often immediate but may take up to 72 hours. Patients may resume normal activity within 24-48 hours. They may experience some discomfort or bruising where the needle was inserted.

Patients are instructed to:

• Use prescribed pain medication, muscle relaxers, and laxatives as directed.
• If instructed to, wear brace as directed.
• Remove the bandages on incision after 24 hours - there are NO stitches to remove.
• Wait 24 hours before showering or soaking in a bathtub.
• Do NOT do any heavy lifting for 3 months (i.e. nothing heavier than a carton of milk). Then gradually increase lifting to normal. Walking is encouraged and bending can be done within the restrictions of the brace.
• Schedule a return clinic visit approximately 6 weeks after surgery.
• Watch for signs of fever, chills, warmth, redness, or drainage from incision. A slight amount is normal for a day or two following surgery.

We follow up with the patient by telephone or office visit at prescribed intervals to assess the response to treatment and the durability of the results. However, post procedural imaging of the treated levels is not considered cost effective and therefore infrequently obtained.

Although pain is reduced or eliminated after the procedure, patients must exercise caution in subsequent activities because other osteoporotic vertebral bodies may also be prone to fracture. Medical management of the underlying disorder that weakens the vertebral bodies should be initiated because this procedure does not eliminate the need for aggressive treatment of osteoporosis, without which other fractures may ensue.

Ideally, treatment should include:

• Medications to treat osteoporosis (such as Actonel; Fosamax; Miacalcin)
• A well-balanced diet
• A regular exercise or activity program
• Smoking cessation
• Calcium supplements
• Multivitamins (including vitamins C and D)
• Hormonal replacement therapy should also be considered in female patients
• Alteration/Evaluation in the medications and dosage of drugs that predispose the patients to osteoporosis (e.g., steroids)

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