About Your Vertebral Augmentation Procedure

This information will help you prepare for your vertebral augmentation procedure at Memorial Sloan Kettering (MSK).

Vertebral augmentation is a procedure to help stabilize a weak or fractured vertebrae (bone in your back). There are 2 types of vertebral augmentation procedures:

  • Vertebroplasty
    • During this procedure, bone cement is injected into your weak or fractured bone to make it stable.
  • Kyphoplasty
    • During this procedure, a balloon is inserted into your back through a needle and inflated to create space. Then, bone cement is injected into your weak or fractured bone.

A doctor called a neuroradiologist will perform your vertebral augmentation procedure. Neuroradiologists specialize in reading images of the brain and spine. Your neuroradiologist will perform your procedure using these images as a guide.

Before Your Procedure

Ask about your medications

You may need to stop taking some of your medications before your procedure. Talk with your doctor about which medications are safe for you to stop taking. We have included some common examples below.

If you take medication that affects the way your blood clots, ask the doctor performing your procedure what to do. The doctor’s contact information is listed at the end of this resource. Some examples of these medications are:

apixaban
(Eliquis®)
dalteparin
(Fragmin®)
meloxicam
(Mobic®)
ticagrelor
(Brilinta®)
aspirin
 
 
dipyridamole
(Persantine®)
 
nonsteroidal anti-inflammatory
drugs (NSAIDs) such as ibuprofen
(Advil®) or naproxen (Aleve®)
tinzaparin
(Innohep®)
 
celecoxib
(Celebrex®)
edoxaban
(Savaysa®)
pentoxifylline
(Trental®)
warfarin
(Coumadin®)
cilostazol
(Pletal®)
enoxaparin
(Lovenox®)
prasugrel
(Effient®)
 
clopidogrel
(Plavix®)
Fondaparinux
(Arixtra®)
rivaroxaban
(Xarelto®)
 
dabigatran
(Pradaxa®)
heparin
(shot under your skin)
sulfasalazine
(Azulfidine®, Sulfazine®)
 
 

Whether he or she recommends you stop taking it will depend on the reason you are taking it. Do not stop taking any of these medications without talking with your doctor.

Please review the information in the resource Common Medications Containing Aspirin and Other Nonsteroidal Anti-Inflammatory Drugs (NSAIDs). It includes important information about medications you’ll need to avoid before your procedure and what medications you can take instead.

If you take insulin or other medications for diabetes, you may need to change the dose before your procedure. Ask the doctor who prescribes your diabetes medication what you should do the morning of your procedure.

If you take any diuretics (medications that make you urinate more often), you may need to stop taking them the day of your procedure. Some examples are furosemide (Lasix®) or hydrochlorothiazide. Speak with your doctor.

Arrange for someone to take you home

You must have someone 18 years or older take you home after your procedure. If you don’t have someone to do this, call one of the agencies below. They will provide someone to accompany you home; however, there is usually a charge for this service and you will also need to provide transportation.

In New York:

     Partners in Care: 888-735-8913

     Prime Care: 212-944-0244

In New York or New Jersey:

     Caring People: 877-227-4649

Tell us if you’re sick

If you develop any illness (fever, cold, sore throat, or flu) before your procedure, please call a nurse in Interventional Radiology at 212-639-2236. A nurse is available Monday through Friday, 9:00 am to 5:00 pm. After hours, during the weekend, and on holidays, call 212-639-2000 and ask for the neuroradiology fellow on call.

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2 Days Before Your Procedure

Note the time of your appointment

A staff member from Interventional Radiology will call you 2 business days before your procedure. They will tell you what time you should arrive at the hospital for your procedure. If your procedure is scheduled on a Monday, you will be called on the Thursday before. If you don’t receive a call by 12:00 pm on the business day before your procedure, please call 212-639-5051.

If you need to cancel your procedure for any reason, please call the doctor who scheduled it for you.

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The Day of Your Procedure

Between midnight and up until 2 hours before your scheduled arrival time, you may drink a total of 12 ounces of clear liquids (see Figure 1).

Figure 1. 12 ounces of clear liquid

Examples of clear liquids include:

  • Water
  • Clear broth, bouillon, or consommé (no particles of dried food or seasonings) 
  • Gelatin, such as Jell-O® 
  • Clear fruit juices (no pulp), such as white cranberry, white grape, or apple 
  • Soda, such as 7-Up®, Sprite®, ginger ale, seltzer, or Gatorade® 
  • Coffee or tea, without milk or cream 

Things to remember

  • Take your medications the morning of your procedure as instructed by your doctor. Take them with a few sips of water.
  • Don’t use any cream or petroleum jelly (Vaseline®). You can use deodorant and light moisturizers. Don’t wear eye makeup.
  • Don’t wear any metal objects. Remove all jewelry, including body piercings.
  • Leave valuables, such as credit cards or jewelry at home.
  • If you wear contact lenses, wear your glasses instead. If you don’t have glasses, please bring a case for your contacts.

What to bring with you

  • A list of the medications you take at home
  • Medications for breathing problems (such as inhalers), medications for chest pain, or both
  • A case for your glasses or contacts
  • Your Health Care Proxy form, if you have completed one
  • Your C-Pap or Bi-pap machine, if you use one to sleep at night. If you can’t bring your machine, we will give you one to use while you’re in the hospital.

Where to park

MSK’s parking garage is located on East 66th Street between York and First Avenues. To reach the garage, turn onto East 66th Street from York Avenue. The garage is located about a quarter of a block in from York Avenue, on the right-hand (north) side of the street. There is a pedestrian tunnel that you can walk through that connects the garage to the hospital. If you have questions about prices, call 212-639-2338.

There are also other garages located on East 69th Street between First and Second Avenues, East 67th Street between York and First Avenues, and East 65th Street between First and Second Avenues.

Where to go

Go to 1275 York Avenue, between East 67th and East 68th Streets. This is the main building of MSK. Take the M elevator to the 2nd floor.

What to expect

Once you arrive at the hospital, doctors, nurses, and other staff members will ask you to state and spell your name and date of birth many times. This is for your safety. People with the same or similar name may be having a procedure on the same day.

Your nurse will put in an intravenous (IV) line in your hand or arm. You will receive medication through your IV to make you feel drowsy.

When it is time for your procedure, you will be brought into the procedure room and helped onto an exam table. A member your healthcare team will help position you onto your stomach. You will receive oxygen through your nose.

Your back will be cleaned and covered with sterile drapes. A local anesthetic will be injected in the area where your doctor will be working. You will also get general anesthesia (medication to make you sleep).

Images of the area will be taken so the needles can be placed in the right place. If necessary, a balloon will be inserted and inflated to make a space for the cement. Next, the cement-like substance will be injected into the area to make it stronger. This will be repeated on all of the vertebrae that are having the augmentation procedure.

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After Your Procedure

In the recovery room

You will be brough to the recovery room after your procedure. Your nurse will monitor your injection site(s) for any bleeding. Most people are in the recovery room for at least 2 hours.

Tell your nurse if you have:

  • Increasing pain or discomfort
  • Shortness of breath or trouble breathing
  • Any symptoms that concern you

At home

You can shower 24 hours after your procedure. Do not swim, sit in a hot tub, or take a bath for 1 week after your procedure.

Remove the bandage and wash the injection site(s) with soap and water. Gently dry the area with a clean towel. You may place a clean bandage over the area.

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Call Your Doctor or Nurse if You Have:

  • Pain that is uncontrolled or worse than it was before your procedure
  • Redness, swelling, or drainage around the needle marks on your back
  • A temperature of 101° F (38.3° C) or higher
  • Any symptoms that are worrying you
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