Patient will be induced and turned prone. Have lead ready. 1-2 C-arms will be utilized to find the correct position. Quick procedure - some practitioners opt to use paralytics to ensure the patient remains motionless (general anesthetic), while others just keep the patient deep. The MAC approach - some suggest that MAC sedation can be used for this procedure. The patient positions themselves and then sedation is given. A sample approach: Versed 1-2 mg (age dependent). Glycopyrrolate 0.2 mg to decrease secretions from ketamine. Fentanyl 50 mcg and Precedex 8-12 mcg for positioning. Goggles and O2 on the patient just prior to positioning themselves. Then give Ketamine 20-50 mg (20 mg bolus and then 10 mg each dose as needed up to 50 mg). Propofol infusion is typically titrated between 75-150 mcg/kg/min.
This procedure is designed to give some reinforcement to a collapsing vertebral column. The procedure is very often done for those who have a compression fracture or simply a weakened vertebral column. If not corrected, the collapsing bone can lead to chronic pain, kyphosis or dowager’s hump, and loss of height. Both a vertebroplasty and a kyphoplasty are collectively called vertebral augmentations. Both involve injection of bone cement into the spinal column. In a kyphoplasty, however, balloons are used to expand the space in the vertebral column prior to injecting the bone cement.
