back (decrease of the lumbar curve) and fracture of the vertebral body and/ or pedicle
may also occur. Of late, dynamic stabilization implants have been introduced as an
alternative to rigid fixation. This technique allows the spine to be more flexible and
pliant and thereby hopes to reduce some of the complications listed above.
Dynamic stabilization is a semirigid type of stabilization in which a material is used that
is similar to the elasticity of natural bone. Although this form of fusion does not
completely prevent stress in the adjoining discs and joints, the dynamic component of
this stabilization technique may minimize its occurrence.
A number of devices are currently in use for dynamic stabilization and MANY ARE
STILL IN THE TRIAL PHASE. While this technique may be better than
traditional fusion or rigid instrumentation procedures, long term results
are still unequivocal. It is best to regard these surgical operations as
experimental till the jury returns with a better verdict.
Surgery for Vertebral Compression FracturesVertebroplasty
Vertebroplasty is a minimally invasive, non-surgical procedure that is designed to
relieve the pain of compression fractures. Vertebroplasty literally means repairing the
vertebral body. In addition to relieving pain, those vertebral bodies that are weakened
but not yet fractured can be strengthened, thus preventing future problems.
Under general anesthesia, or sometimes under sedation, a special bone needle is passed
slowly through the soft tissues of the back. Image guided x-ray, along with a small
amount of x-ray dye, allows the position of the needle to be seen at all times. A small
amount of orthopaedic cement, called polymethylmethacrylate (PMMA), is pushed
through the needle into the vertebral body. PMMA is medical-grade bone cement that
has been used for many years in a variety of orthopaedic procedures. The cement is
mixed with an antibiotic to reduce the risk of infection, and a powder containing barium
or tantalum, which allows it to be seen on the x-ray. When the cement is injected, it is
like a thick paste, but it hardens rapidly. Usually each vertebral body is injected on both