It can happen without warning.
An older woman bends to lift a bag of groceries. A man steps off a curb awkwardly. Sometimes there’s no specific incident at all — just a gradual onset of severe mid or lower back pain that doesn’t go away.
The culprit is often a vertebral compression fracture (VCF) — a fracture of the vertebral body, most commonly caused by osteoporosis.
And for many of these patients, vertebroplasty offers a solution that most have never heard of — but that can transform their quality of life within 24 hours.
What Is a Vertebral Compression Fracture?
Osteoporosis causes progressive loss of bone density. The vertebral bodies — the bony blocks that make up the spine — become increasingly fragile. Under normal daily loads, or with minimal trauma, these weakened vertebrae can collapse on themselves.
The result is:
- Severe, acute back pain — often described as the worst pain the patient has experienced
- Height loss and progressive kyphosis (forward stoop) with multiple fractures
- Significant functional limitation — difficulty sitting, standing, walking
- Respiratory compromise in severe cases with thoracic involvement
In India, with a large elderly population and widespread vitamin D deficiency, osteoporotic vertebral fractures are a significant and underdiagnosed problem.
What Is Vertebroplasty?
Vertebroplasty is a minimally invasive percutaneous procedure in which bone cement (polymethylmethacrylate, PMMA) is injected into the fractured vertebral body under fluoroscopic (X-ray) guidance.
The cement stabilises the fracture, restores structural integrity, and — through a combination of mechanical stabilisation and thermal effects on pain receptors — provides rapid, often dramatic pain relief.
Kyphoplasty is a related procedure in which a balloon is first inflated within the vertebral body to restore height before cement injection — this is preferred when significant height loss or kyphotic deformity is present.
The Vertebroplasty Procedure — Step by Step
Step 1: Patient Positioning
The patient lies prone (face-down) on the operating table.
Step 2: Anaesthesia
Local anaesthesia with sedation, or spinal/general anaesthesia depending on patient fitness.
Step 3: Needle Placement
Under fluoroscopic guidance, a trocar is advanced through the pedicle of the fractured vertebra into the vertebral body.
Step 4: Cement Injection
PMMA bone cement is injected under continuous fluoroscopic monitoring to ensure containment within the vertebral body.
Step 5: Recovery
Procedure time is 30–60 minutes per level. The patient is mobilised within hours of completion.
Who Is a Candidate for Vertebroplasty?
Indicated For:
- Acute or subacute osteoporotic vertebral compression fractures with significant pain unresponsive to conservative management
- Pathological fractures due to spinal metastases (tumour involvement of the vertebral body)
- Selected cases of vertebral haemangioma with pain or instability
Not Appropriate For:
- Fractures with significant posterior wall compromise and neural compression
- Active spinal infection
- Uncorrected coagulopathy
- Asymptomatic fractures
The ideal candidate is a patient with acute VCF, significant pain, confirmed fracture on MRI (bone marrow oedema indicating acute injury), and failure of 4–6 weeks of conservative management.
What the Evidence Says — Clinical Outcomes
The evidence for vertebroplasty in appropriately selected patients is robust:
- Significant pain reduction in 80–90% of patients
- Rapid onset of relief — often within 24–48 hours
- Improved functional outcomes and mobility
- Reduced analgesic requirement
- Prevention of further vertebral collapse at the treated level
Early intervention (within 6–8 weeks of fracture) yields better outcomes than delayed treatment.
Don’t Forget the Underlying Osteoporosis
Vertebroplasty treats the fracture. It does not treat osteoporosis.
Every patient who undergoes vertebroplasty for an osteoporotic fracture must be referred for formal osteoporosis management — DEXA scanning, vitamin D and calcium supplementation, and bisphosphonate or other antiresorptive therapy where indicated. Failure to address the underlying condition leaves patients at high risk of further fractures.
This requires coordination between the spine surgeon, endocrinologist, and general physician.
For Patients in Chennai
If you or an elderly family member has developed severe back pain — particularly if they have a known history of osteoporosis, are on long-term steroids, or have had a recent minor fall — a vertebral fracture must be excluded.
Do not assume it is “just muscle pain.” An MRI of the spine takes 30 minutes and can identify an acute fracture that is treatable.
Dr. Balaji Bashyam performs vertebroplasty and kyphoplasty at MGM Healthcare, Chennai.
For appointments: Pavithram Speciality Clinic, Choolaimedu, Chennai | MGM Healthcare
Tamil Nadu Medical Council Reg. No. 94799
Frequently Asked Questions — Vertebroplasty
How painful is vertebroplasty?
The procedure itself is performed under local anaesthesia with sedation, so patients experience minimal discomfort during the procedure. Most patients report significant pain relief within 24–48 hours of the procedure.
What is the difference between vertebroplasty and kyphoplasty?
In vertebroplasty, bone cement is injected directly into the fractured vertebra. In kyphoplasty, a balloon is first inflated inside the vertebra to restore height and create a cavity before cement injection. Kyphoplasty is preferred when significant height loss or kyphotic deformity is present.
How long does vertebroplasty take?
The procedure typically takes 30–60 minutes per vertebral level. Most patients are mobilised within a few hours of completing the procedure.
Is vertebroplasty available in Chennai?
Yes. Dr. Balaji Bashyam performs vertebroplasty and kyphoplasty at MGM Healthcare, Aminjikarai, Chennai. Please contact the clinic for appointments and evaluation.