Percutaneous vertebroplasty is a method that was started to be applied in Europe in 1984 and is widely used. In the United States, it became the standard method for painful compression fractures in the 1990s. Kyphoplasty or “balloon-assisted vertebroplasty” started to be used in the treatment of pain due to compression fractures of the spine at the end of the 1990s. Both methods are structurally similar and aim to percutaneously transfer the bone cement to the fractured or destroyed vertebral body and strengthen the body.
A 47-year-old female patient who was referred to another center for liver (liver) transplantation applied to the emergency department of our hospital with severe low back pain that started 10 days ago after a fall. Radiologic examinations revealed an L3 acute osteoporotic compression fracture. The patient was consulted for general anesthesia in anesthesia and gastroenterology departments and was given ASA-IV(E) and medium-high risk, respectively. We thought that kyphoplasty with local anesthesia was appropriate for the patient. Bone cement was applied to the L3 vertebral body in closed surgery. There were no complications. No dietary restrictions were made for the surgery. He was aroused at the 4th hour postoperatively and discharged at the 15th hour. His pain was reduced by 90%.
Thus, we have been protected from co-morbidities caused by long-term bed rest and corset application, the side effects of long-term drug therapy or the complications of a more aggressive surgery to be performed. Most of the vertebroplasty/kyphoplasty applications in our clinic (90%) are performed with local anesthesia and/or sedoanalgesia. Another advantage in vertebroplasty/kyphoplasty applications performed with local anesthesia is that we can control the leg movements of the patient during the operation. In patients with low pain threshold, sedoanalgesia can be added during surgery.
