RAIPUR,CG: For the first time in Chhattisgarh, the Department of Radiology at Pandit Jawaharlal Nehru Memorial Medical College and Dr. Bhimrao Ambedkar Memorial Medical College Hospital performed vesselplasty on a 79-year-old elderly woman suffering from non-healing vertebral compression fracture (spine fracture).

Interventional Radiologist Dr. (Prof.) Vivek Patre said the treatment procedure involves injecting bone cement with the help of a needle through a porous bone filling balloon container system. It provides relief from compression.

In vertebral compression, the spinal cord breaks or gets compressed. Compression fracture also occurs in spine cancer. Generally, bones become weak with increasing age, then even a minor injury can cause the problem. If the disease or problem continues for a long time, it presses the spinal cord located inside the spinal canal, due to which the part below the waist stops functioning and the patient becomes paralyzed, he added.

Dr Patre said earlier the facility of vesselplasty was available only in big hospitals of metropolitan cities, but this is the first time the procedure has been done in any hospital of the state.  The woman had D (dorsal) 12 vertebral fracture due to which she was suffering from unbearable pain for the last 9 months. She was not able to sit for the last one month.

He adds, after the entire needle puncture procedure, the woman was able to sit after half an hour and was discharged on the same day. Although any procedure is risky in patients of such an advanced age. The team prepared for the procedure by taking the risk. The middle three minutes were crucial.

He adds the challenge was that polymethyl methacrylate i.e. bone cement has to be prepared and injected within three minutes because if it is delayed then the bone cement will immediately convert into solid state in the outside environment. To avoid it the bone cement was kept in a low temperature inside the refrigerator before the procedure so that it gets frozen slowly while being injected into the body.

How the procedure was done

Dr. Vivek Patre explained that vesselplasty is an imaging-guided procedure that provides a safe method for the treatment of vertebral compression fractures. First of all the place where vesselplasty is done was numbed. A thick needle was inserted. From inside that thick needle, a place was made at a certain place in the vertebral body through a manual drill. Then, under fluoroscopy and DSA machine, bone cement was injected inside the balloon container with the help of a needle. The balloon is porous allowing a small amount of bone cement to pass through its wall and become implanted through the holes inside the vertebral body. Due to the porous structure of the balloon, there is no leakage and spread of cement from the vertebral body, due to which it does not spread into the spinal canal or lungs and there is no possibility of complication.

New Technology

Vesselplasty is a fairly new technique. Vertebroplasty was procedure was done in which bone cement was inserted inside the vertebral body after reaching the vertebral body through a pedicle, then there was a possibility of leakage in the spinal canal due to the insertion of bone cement. If cement accidentally enters the lungs through a spinal vein, there is a possibility of pulmonary embolism. Next came kyphoplasty. In kyphoplasty, space was created by inserting a balloon inside the body and bone cement was placed in that space.

And used to put bone cement in that place. This also had the same risk but was less than vertebroplasty. Vesselplasty is the latest technology and till now its facility was available only in metropolitan cities.