About Your Vertebral Augmentation Procedure: Kyphoplasty and Vertebroplasty

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

There are 2 types of vertebral augmentation procedures:

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

If you have a tumor that has grown into your spine, you may also have radiation therapy. The radiation therapy will treat the tumor, help make your spine stronger, and control your pain. Your doctor will review the images of your spine taken during your MRI. He or she will then talk with you about whether radiation therapy is an option for you.

Vertebral augmentation procedures are performed in the Radiology Department. The specific area is called Interventional Radiology (IR). The doctor who performs this procedure is called a neuroradiologist. He or she specializes in reading images of the brain and spine and performs the 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. We have included some common examples below.

  • If you take medication to thin your blood, ask the doctor performing your vertebral augmentation what to do. Some examples are aspirin, warfarin (Coumadin®), dalteparin (Fragmin®), heparin, tinzaparin (Innohep®), enoxaparin (Lovenox®), clopidogrel (Plavix®), cilostazol (Pletal®), prasugrel (Effient®), and ticlopidine (Ticlid®). These medications might be used to treat blood clots or to prevent a heart attack or stroke.
  • If you take insulin or other medications for diabetes, you may need to change the dose before your procedure. Ask the doctor performing your vertebral augmentation what you should do the day before and the morning of your procedure.
  • Do not take vitamin E 10 days before your procedure

Arrange for someone to take you home

You must have someone 18 years or older take you home after your procedure. Please call one of the agencies below if you don’t have someone who can do this. They will help find someone to take you home.

Partners in Care 888-735-8913

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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The Day Before Your Procedure

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

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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:

  • 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 only the medications your doctor told you to take the morning of your procedure. Take them with a few sips of water.
  • Do not apply cream or petroleum jelly (Vaseline®). You may use deodorant and light moisturizers.
  • Remove any jewelry, including body piercings.
  • Leave all valuables such as credit cards and jewelry at home.
  • If you wear contact lenses, if possible, wear your glasses instead. If you don’t have glasses please bring a case for your contacts.
  • If you use a C-Pap or Bi-pap machine to sleep at night, if possible please bring your machine in. If you can’t bring your machine we will give you one to use while you are in the hospital.

What to bring with you

  • A list of the medications you take at home
  • Medications for breathing problems (such as inhalers) or medications for chest pain or both
  • A case for your glasses or contacts
  • Your Health Care Proxy form, if you have completed one

Where to park

Parking at MSKCC is available in the garage on East 66th Street between First and York Avenues. To reach the garage, enter East 66th Street from York Avenue. The garage is located about  a quarter of a block toward First Avenue, on the right (north) side of the street. A tunnel connects the garage to the hospital. There are also nearby commercial garages: 4 on East 69th Street between First and Second Avenues and 3 on East 65th Street between First and Second Avenues. For questions about pricing, call 212-639-2338.

Where to go

Please arrive at the main building of MSKCC at 1275 York Avenue . Take the M elevator to the 2nd floor. Enter through the glass doors and check in at the desk.

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. Patients with the same or similar names may be having procedures on the same day.

After changing into a hospital gown, you will meet your nurse. He or she will place an intravenous (IV) catheter into a vein, usually in your hand or arm. At first, you will receive liquids through the IV, but it will be used later to give you anesthesia (medication to make you sleepy).

When it is time for your procedure, you will be brought into the procedure room and helped onto an exam table. You will be attached to equipment to monitor your heart, breathing, and blood pressure. You will also receive oxygen through your nose. A member of our clinical team will help position you onto your stomach. 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. Images of the area will be taken so the needles can be placed in the right place. Next, the cement-like substance will be injected into the area to make it stronger.

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After Your Procedure

In the recovery room

You will wake up in the recovery room. Your nurse will continue to monitor your pain, heart, breathing, and blood pressure. He or she will monitor your punture site for any bleeding. Once you’re ready, he or she will remove your IV. If you have someone waiting with you, your nurse will explain your discharge instructions to both of you before you go home. Most patients are in the recovery room for at least 2 hours.

At home

Do not swim, sit in a hot tub, or take a bath for 1 week after your procedure. Unless your nurse or doctor tells you not to, you can start showering 24 hours after your procedure. Remove the bandage and wash the injection area with soap and water. Gently dry the area with a clean towel. You may want to place a clean Band-Aid® over the area if there is any drainage.

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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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