VERTEBRAL COMPROMISE TREATMENT IN LYON
Avertebral compactionis a fracture of the body of the vertebra which can occur after a major trauma for a normal bone, or a more minor or even spontaneous trauma in the event of a previously weakened bone such as byosteoporosisor by acancer metastasis.
Depending on the quality of the underlying bone, its capacity for spontaneous healing will therefore be different, more or less quick and easy. The vertebral fracture can thus generate pain and immobilization with repercussions on the quality of life and the occurrence of complications if it is insufficiently treated.
The evolution of a vertebral compression can also be done with an angulation in progressive kyphosis with sagittal imbalance of the rachis at term (patient "hunted" forward).
What is cementoplasty or vertebroplasty?
Also calledVERTEBROPLASTYwhen the treatment concerns a vertebra, cementoplasty is atreatmentminimally invasive imaging-guidedLyonsfor weakened bones, with compression or fracture, and often painful.
theinterventional radiologistwill guide a miniature needle through your back into the affected bone under imaging control. He will then inject very precisely into the weakened area an orthopedic cement which will solidify in a few minutes.
thetreatmentis done on the stomach under sedation by an anesthesia team and on an outpatient basis.
Cementoplasty therefore has two objectives:consolidation of bonereached directly by the cement inside, or/and theassociated pain treatment.
The main causes of embrittlement or fracture areosteoporosis(vertebral compression), accidents withspinal trauma, and thebone metastases from cancer. The vertebrae are most often affected, but thetreatmentcan be done on the pelvis, femur, humerus, ribs, sternum etc...
Like any gesture ofinterventional radiology,theradiologistwill see you before in consultation with the necessary examinations to confirm the indication. He will explain to you the procedure for the treatment, the expected benefit depending on your situation, and any theoretical complications.
In the event of a collapsed vertebra with kyphosis (angulation in front of the back), an additional associated gesture of vertebral restoration can be offered to you during the same intervention. Using a small balloon (kyphoplasty) or a small implant (SpineJack), the height of the vertebra is first found and then cement injected.
In case of collapse linked to a metastasis, an associated gesture of destruction of the cancer can be associated in the same intervention. Before injecting the cement, the interventional radiologist will always insert through the same millimetric working cannula a needle to create a burn on the cancer using heat (radiofrequency) or cold (cryotherapy)
In the event of an unstable fracture, stabilization or decompression surgery may be associated.
CEMENTOPLASTY IN IMAGE
Tassements vertébrauxTassements des corps vertébraux des 3 denières vertèbres lombaires, douloureux malgré un traitement comprenant de la morphine. | Fractures du sacrumDouble fracture des ailes iliaques associées, plus marquée à gauche | Visée scannerSous anesthésie, utilisation du scanner pour l'insertion précise du trocard à travers le pédicule dans le corps vertébral tassé. |
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Aiguille en placePassage en radiographie de profil pour vérifier la bonne position du trocard dans l'os et préparer l'injection du ciment. | Injection du cimentInjection du ciment sur la vertèbre inférieur avec une surveillance directe et continue par radio de sa répartition au sein de l'os | Fin d'injectionInjection satisfaisante du ciment dans les vertèbrs sans fuite et retrait des trocard. Pas de point de suture. |
Visée scanner sacrumProcédure identique pour les fractures du sacrum. Ici un trajet oblique ascendant postérieur à été réalisé grâce à un porcédure de navigation (Imactis) pour être parfaitement dans l'axe des fractures. | Fin d'injectionLe ciment a parfaitement rempli la fracture sur l'aileron sacré droit. | Contrôle final 3DControle du ciment (bleu) remplissant parfaitement les 3 corps vertébraux atteinds et les 2 fractures des ailerons sacrés. Le patient a pu sortir le lendemain matin sans aucune douleur en arrêtant de suite sa morphine. |
Frequent_questions_cc781905-5cde-3194-bb3b-136bad5cf58d
How is vertebroplasty performed?
First of all, the radiologist sees you in consultation in Lyon or in video with the imaging examinations adapted to your situation (scanner and/or MRI of the spine).
It confirms the possibility of treatment and tells you its practical course, the expected benefit and any theoretical complications.
You will be treated on an outpatient basis during the day. In the operating room, radiology devices (scanner or cone-beam CT) make it possible to make a new assessment of the bonesreach then targetprecisely the sick part. A needle a few millimeters in diameter is inserted into it to deliver the cement.
After the gesture you have a prescription formedications against pain if needed but pain remains very rare.
If the pain was mechanical, it will disappearrapidly in the next few days. There is no convalescence or rehabilitation specific to cementoplasty.
The radiologist will then see you again in consultation with new imaging if necessary, and will evaluate theefficiency du gesture. If necessary, he will prescribe additional manual care (physiotherapy, osteopathy) or appropriate medication.
In the event of a fracture due to bone insufficiency, a consultation with a rheumatologist will also be indicated.
And after vertebroplasty, is it painful?
Vertebroplasty should not cause postoperative pain, which remains exceptional. The bone is consolidated immediately and the relief of the mechanical pain associated with the fracture must be rapid.
If pain persists after the consolidation of your collapse, the radiologist will implement the drug and physical treatments necessary for optimal rehabilitation.
You want to know more?
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