My father had a percutaneous vertebroplasty two weeks ago for back pain from a vertebral compression fracture. So far there’s been no change in his pain. What should we do? Wait longer? Try again?

Most patients can expect partial pain relief (if not complete pain relief) 24 hours after a percutaneous vertebroplasty (PV). PV is the injection of cement into a fractured vertebrae. A needle is inserted through a tiny hole or incision cut in the skin. The cement is injected into the center of the vertebrae.

If pain is not relieved after two weeks, a follow-up visit is advised. The surgeon may still want to try analgesics (pain relievers), bed rest, and/or bracing. Sometimes a short course of physical therapy is helpful.

If conservative management is not successful, a second PV can be done. There are very few (if any) adverse effects of this procedure. Too much cement can cause leakage and irritation of the nearby spinal nerve root. Not enough cement can result in a failed procedure.

A small study of 15 patients with persistent pain after a primary (first) PV had good results after a second PV. Three-fourths of the patients got complete relief of pain. The rest had partial pain relief. There were no complications or problems from the injection.

There is help for patients with painful vertebral compression fractures. Consult with your father’s surgeon to find out what is the next step.