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Vertebroplasty Spine Fracture Treatment In Mumbai
Minimally Invasive Bone Cement Injection for Painful Vertebral Compression Fractures
Vertebroplasty is a minimally invasive interventional radiology procedure in which medical-grade bone cement (PMMA) is injected directly into a fractured vertebra under X-ray image guidance to stabilise the fracture, relieve severe back pain, and restore spinal integrity. At Shree Hospitals, our specialist interventional radiologists perform vertebroplasty for osteoporotic vertebral compression fractures, pathological fractures from bone metastases, and multiple myeloma affecting the spine, providing rapid and durable pain relief when conservative treatment has failed.
Severe Back Pain from a Spine Fracture? Ask About Vertebroplasty Today
Quick facts
Procedure Type : Percutaneous Vertebral Bone Cement Augmentation
Anaesthesia : Local Anaesthesia with Conscious Sedation
Duration : 45 to 90 minutes
Hospital Stay : 1 day (day case in selected patients)
Recovery Time : Most patients ambulate the same day
Support Team : Interventional radiologists, spine specialists, rheumatologists
Key Benefit : Rapid pain relief, spine stabilisation, early mobilisation
What is Vertebroplasty?
Vertebroplasty is a procedure in which polymethylmethacrylate (PMMA) bone cement - a strong, fast-setting acrylic material - is injected into a collapsed or fractured vertebral body through a needle placed under fluoroscopic (X-ray) guidance. The cement fills the fracture lines and void within the vertebra, hardens within minutes, and acts as an internal cast that stabilises the fracture and prevents further collapse. The mechanical stabilisation of the fractured vertebra is the primary mechanism of pain relief in vertebroplasty.
Vertebral compression fractures (VCF) are the most common complication of osteoporosis, affecting approximately 25% of postmenopausal women and a significant proportion of older men. The vertebra - weakened by bone loss - fractures under normal body weight or minor trauma, causing the body of the vertebra to collapse. This results in sudden, severe back pain, height loss, spinal kyphosis (stooped posture), and reduced mobility. Vertebroplasty is also used for pathological fractures of vertebral bodies caused by bone metastases (cancer spread to the spine) and multiple myeloma (a blood cancer that weakens bone).
At Shree Hospitals, vertebroplasty is performed by our interventional radiology team in close collaboration with spine specialists, rheumatologists, and oncologists. All patients with osteoporotic fractures receive concurrent osteoporosis management including calcium and vitamin D supplementation, bisphosphonate or denosumab therapy, and fall prevention counselling to prevent further fractures. For cancer patients with vertebral metastases, vertebroplasty is integrated into the overall oncological treatment plan.
Who Should Be Assessed for Vertebroplasty?
Vertebroplasty is indicated for:
- Osteoporotic vertebral compression fractures causing severe back pain that has not responded to 4 to 6 weeks of conservative management (bed rest, analgesia, bracing)
- Acute vertebral fractures (under 3 months) confirmed on MRI as active (oedema within the fractured vertebra)
- Pathological vertebral fractures from bone metastases or multiple myeloma causing pain and instability
- Patients unable to tolerate prolonged bed rest or analgesia due to medical co-morbidities
- Patients in whom pain is preventing mobilisation, causing deteriorating function and risk of complications from immobility
Is Vertebroplasty the Right Treatment for Your Spinal Fracture?
Vertebroplasty is most appropriate when:
- MRI of the spine confirms an acute or subacute vertebral compression fracture with bone marrow oedema (indicating an active, painful fracture)
- Conservative treatment including analgesia, bed rest, and spinal bracing has failed to provide adequate pain control after 4 to 6 weeks
- The fracture is causing significant functional limitation (inability to walk, care for oneself, or tolerate normal activity)
- There is no neurological deficit (weakness in the legs, bowel or bladder problems) requiring surgical spinal decompression
- The vertebral body is not too severely collapsed to allow safe cement injection
Why Treating Vertebral Fractures Early Matters?
Untreated vertebral compression fractures lead to progressive complications:
- Prolonged bed rest from uncontrolled pain causes deep vein thrombosis, pneumonia, muscle wasting, and pressure sores - particularly dangerous in elderly patients
- Progressive vertebral collapse can worsen deformity and cause spinal cord compromise if left untreated
- Spinal kyphosis (rounded back) impairs breathing by reducing chest expansion
- Multiple vertebral fractures significantly increase mortality in osteoporotic patients
- Vertebroplasty relieves pain rapidly, enabling early mobilisation and preventing these secondary complications
Vertebroplasty provides significant pain relief in over 80 to 90% of patients with acute osteoporotic vertebral compression fractures.
At Shree Hospitals, our interventional radiology team performs vertebroplasty for appropriately selected patients with painful vertebral fractures, using precise fluoroscopic guidance and high-viscosity bone cement to achieve rapid stabilisation and durable pain relief.
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Our Approach to Vertebroplasty
At Shree Hospitals, vertebroplasty is performed only after careful patient selection based on MRI confirmation of an active fracture and failure of adequate conservative management. Our interventional radiology team works closely with spine specialists, rheumatologists, and oncologists to ensure every patient receives the most appropriate treatment for their fracture type and underlying bone disease.
24×7 Emergency Care
MRI-Based Patient Selection
Every vertebroplasty candidate undergoes MRI of the thoracolumbar spine to confirm the presence of active (acute or subacute) fractures demonstrated by bone marrow oedema on STIR or fat-saturated sequences. MRI also identifies any retropulsed fracture fragments in the spinal canal (which would require surgical decompression rather than vertebroplasty), assesses the degree of vertebral collapse, and identifies any posterior cortex disruption that increases the risk of cement leakage. Old, healed fractures without oedema are not suitable for vertebroplasty.
Precision Fluoroscopy-Guided Cement Injection
Vertebroplasty is performed in our angiography suite under biplane fluoroscopic guidance with the patient lying prone. A 11 to 13-gauge bone biopsy needle is advanced through the pedicle of the fractured vertebra (transpedicular approach) under direct X-ray visualisation into the vertebral body. High-viscosity bone cement is prepared and injected slowly in small aliquots under continuous fluoroscopic monitoring to ensure cement fills the fracture without leaking outside the vertebral body.
Real-Time Cement Leak Monitoring
Cement leakage into the spinal canal, disc space, or paravertebral veins is the main technical risk of vertebroplasty. Our team uses high-viscosity cement (which is less likely to flow uncontrollably), injects in small aliquots, and monitors cement spread continuously on fluoroscopy and intermittent CT during the procedure. Injection is immediately stopped if any leak is detected. Most cement leaks are clinically silent but awareness and early detection are essential to avoid the rare but serious complication of neurological injury.
Osteoporosis Management and Fall Prevention
After vertebroplasty, every patient with osteoporotic fractures is referred to our rheumatology and bone health team for comprehensive osteoporosis management including DEXA bone densitometry, calcium and vitamin D supplementation, anti-resorptive therapy (bisphosphonates, denosumab), or anabolic therapy (teriparatide) where indicated. Physiotherapy, fall risk assessment, and home safety advice are provided to reduce the risk of further vertebral fractures.
Interventional Radiologists and Spine Specialists in Mumbai
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10+ years of experience
Dr. Swati Narurkar
Interventional Radiology
Interventional Radiology Services at Shree Hospitals
We offer a comprehensive range of minimally invasive interventional radiology procedures including vertebroplasty, peripheral angioplasty and stenting, IVC filter placement, radiofrequency ablation, UAE, TACE, percutaneous drainage, and biliary drainage, all delivered by specialist interventional radiologists.
Step by Step Process of Vertebroplasty
Step 1 - Clinical Assessment and MRI Review
Your interventional radiologist or spine specialist reviews your history of back pain onset, severity, and response to conservative treatment. MRI of the spine is reviewed to identify active fractures with bone marrow oedema, assess the number of levels affected, and confirm there are no contraindications. The planned procedure and expected outcomes are discussed and consent is obtained.
Step 2 - Pre-Procedure Preparation
Blood tests including clotting profile are checked. Anticoagulant medications (warfarin, novel anticoagulants, antiplatelet agents) are managed according to a standard protocol - most are stopped 3 to 5 days before the procedure. Intravenous access is established and prophylactic antibiotics are given. Conscious sedation medications and local anaesthetic are prepared.
Step 3 - Patient Positioning and Anaesthesia
The patient is positioned prone (face down) on the procedure table with a bolster under the chest and pelvis to reduce spinal flexion. Conscious sedation is given intravenously to ensure relaxation and comfort throughout the procedure. The skin over the target vertebral level is cleaned with antiseptic and local anaesthetic is injected into the skin, subcutaneous tissue, and pedicle periosteum along the planned needle trajectory.
Step 4 - Transpedicular Needle Placement
Under biplane fluoroscopic guidance, an 11 to 13-gauge cannulated bone needle is advanced through the posterior skin along the pedicle of the target vertebra into the fractured vertebral body. The pedicle is a bony corridor that provides a safe path through the vertebra avoiding the spinal canal. Needle position is confirmed in both anteroposterior and lateral fluoroscopic views to ensure the tip is within the anterior third of the vertebral body.
Step 5 - Bone Cement Injection
High-viscosity PMMA bone cement is mixed and allowed to reach optimal working consistency. It is loaded into a delivery syringe and injected slowly in small aliquots under continuous real-time fluoroscopic monitoring. Cement spread within the fractured vertebra is observed. Injection is stopped immediately if cement approaches the posterior cortex, disc space, or paravertebral veins. Sufficient cement is injected to achieve fracture filling and stabilisation.
Step 6 - Recovery and Mobilisatio
After needle removal, the patient rests prone for 30 minutes while the cement hardens fully. The patient is then turned supine and monitored for 1 to 2 hours. Most patients are able to stand and walk on the same day as the procedure. Back pain typically improves within 24 to 48 hours as the fracture is stabilised. Patients are discharged the following morning with instructions on activity progression, osteoporosis medication, and follow-up arrangements.
Patient Questions About Vertebroplasty
How quickly will my back pain improve after vertebroplasty?
Most patients notice significant back pain improvement within 24 to 48 hours of vertebroplasty as the bone cement stabilises the fracture and eliminates the painful movement between fracture fragments. Some patients notice improvement while still on the procedure table. Studies show that 80 to 90% of patients with acute osteoporotic vertebral fractures report significant or complete pain relief after vertebroplasty. The speed and degree of relief is generally greater for acute fractures (under 6 weeks old) than for chronic fractures.
Is vertebroplasty the same as kyphoplasty?
Vertebroplasty and kyphoplasty are both vertebral augmentation procedures that inject bone cement into fractured vertebrae. The key difference is that kyphoplasty first inflates a balloon inside the collapsed vertebra to create a cavity and partially restore vertebral height before injecting cement into the cavity. This theoretically reduces cement leakage risk and may partially correct kyphotic deformity. Vertebroplasty injects cement directly without prior balloon inflation. Our interventional radiologists and spine specialists will advise which technique is most appropriate based on the degree of collapse, fracture type, and vertebral anatomy.
Can vertebroplasty be done at multiple vertebral levels?
Yes. Where multiple vertebral compression fractures are present, vertebroplasty can be performed at several levels in a single session, provided each level has an active fracture confirmed on MRI. Treating multiple levels simultaneously reduces the number of anaesthetic exposures and speeds up overall recovery. The number of levels treated in one session is decided based on the patient's medical fitness, the expected duration of the procedure, and the total cement volume required.
Will vertebroplasty prevent future spine fractures?
Vertebroplasty treats the fractured vertebra but does not address the underlying osteoporosis that caused it. Patients who have had one vertebral compression fracture have a significantly elevated risk of further fractures at adjacent or distant vertebral levels. This is why comprehensive osteoporosis treatment after vertebroplasty is essential - calcium, vitamin D, bisphosphonates or denosumab reduce the risk of further fractures significantly. Fall prevention measures including physiotherapy, home assessment, and visual or balance correction are equally important.
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