Kyphoplasty and vertebroplasty are ultra-minimally invasive surgical procedures that treat vertebral compression fractures of the spine. Both procedures stabilize a spinal compression fracture in the spine to alleviate pain and prevent further loss of vertebral body height.
Compression fractures are estimated to affect 1.5 million Americans each year. They are most common in the elderly, with 25% of postmenopausal women affected by a compression fracture during their lifetime. Most occurrences of these fractures do not require hospitalization.
Compression fractures have the potential to cause significant morbidity and disability, resulting in major back pain for several months.
Osteoporosis caused by bone density loss is the most common condition that can cause vertebral spinal compression fractures. When a vertebra collapses due to a compression fracture, the fracture itself can be painful or cause irritation or even narrowing around spinal nerves resulting in excruciating pain.
Kyphoplasty and vertebroplasty are effective treatment options to reduce pain caused by a vertebral body compression fracture.
Vertebroplasty works percutaneously through the skin to inject bone cement into the vertebral body’s cancellous bone to stabilize the fracture and alleviate pain. The cement interdigitates within the fracture crevices.
Kyphoplasty utilizes an inflatable balloon deployed in the fractured vertebral body creating a cavity for the cement to be injected. The balloon potentially restores the height of the vertebral body and improves alignment by reducing kyphosis (outward curvature of the spine, causing hunching of the back).
Patients with increasingly painful back pain caused by osteoporosis or vertebral compression fractures may be good candidates for vertebroplasty or kyphoplasty.
Patient candidates for these procedures typically have reduced physical function and ability to move because of the fractures in their spine.
Kyphoplasty/Vertebroplasty candidate’s pain must have the following criteria:
Pain due to vertebral fracture
Three types of anesthesia are available for patients and their physicians. Patients undergoing vertebroplasty or kyphoplasty can be offered an epidural analgesic (local anesthetic), IV sedation, or general anesthesia.
The anesthetic used varies according to the specific condition of each patient and the medical team performing the procedure. Each anesthesia has been studied and found effective in helping patients to be comfortable during the procedure.
Step One: patient prepped – the anesthesiologist will administer an anesthetic. Once sedated, the operating room staff will position you comfortably on your stomach on the operating room table. Your back will be cleansed, sterilized, and prepped for the procedure to start.
Step Two: needle placement – your surgeon will begin by injecting a local numbing anesthetic in the area over the fracture vertebrae is located. Under fluoroscopic guidance, the surgeon directs a hollow needle called a trocar through your skin to the affected center of the fractured vertebra.
Step Three: stabilize and restore vertebra height (kyphoplasty only) – through the trocar needle, the surgeon deploys a balloon in the collapsed vertebra. The balloon is then inflated, which creates a cavity and may distract the vertebral endplates to restore vertebral height. The balloon is then deflated and removed.
Step Four: inject bone cement – both vertebroplasty and kyphoplasty inject bone cement which fills and stabilizes the fracture. The amount of cement and pressure is constantly monitored under fluoroscopy to avoid leaks into the spinal canal. Stabilizing the fracture will significantly reduce the pain.
Step Five: dress approach site – the needle/trocar is removed, the small incision is dressed with Steri-Strips placed on the skin and an additional bandage is applied. Once the bone cement has hardened, the patient is moved from the operating room table to the stretcher and taken to recovery for a short period.
During recovery, the clinical team will monitor your heart rate, blood pressure, and respiration. They will assess your pain and medication prescribed by your surgeon with instructions for use after leaving the facility. Patients may sit up shortly after the procedure, get up, and walk after an hour. Some patients may stay overnight for observation and be released the following morning. Most patients can go home that same day. Patients should have someone drive them home and have assistance around the house for the first 48 hours.
Try to walk 5-10 minutes every few hours and gradually increase the walking duration as you feel able to. After the first 72 hours, you can increase physical activities as tolerated and return to all physical work.
The following symptoms can indicate a potential problem. You should call the office to notify the surgeon as soon as possible.
If you have any questions after surgery or experience these symptoms, please call 602-944-2900. Our on-call service will answer calls after hours, and they will page the surgeon in case of an emergency. Otherwise, calls will be returned the following business day.
If you experience any of the following symptoms, please call immediately or dial 911 to go to the emergency room at your local hospital:
The kyphoplasty procedure has been performed on more than 1 million patients safely and effectively over the past 20 years. Balloon kyphoplasty has been clinically proven to relieve pain and restore vertebral body height and deformity. Patient benefits from kyphoplasty include:
The safety of kyphoplasty/vertebroplasty is like nonsurgical measures with a low complication rate. As with any surgical procedure, there are potential for serious adverse events; however, low such as:
Other risks can include – infection and leakage of bone cement into surrounding tissue around the spinal cord. On rare occasions, there can be a risk of paralysis and cement leaking into blood vessels resulting in damage to vessels, lungs, and heart.
You have two options if you have been diagnosed with an acute spinal vertebral compression fracture.
You may be prescribed pain medication and bed rest until it heals over several weeks or months (nonsurgical measures). The other option is a surgical procedure called kyphoplasty or vertebroplasty which can stabilize the fracture.
Your physician can refer you to a specialist who performs kyphoplasty. They can explain the benefits, risks, and if you are a good candidate for the procedure.
As previously explained above, both procedures are similar in that they are ultra-minimally invasive surgical procedures that treat vertebral compression fractures of the spine. Both procedures are vertebral augmentation that relieves back pain and stabilizes a spinal fracture using bone cement.
Kyphoplasty, unlike vertebroplasty, utilizes a balloon to expand the fracture and injects cement. This procedure has been shown to restore vertebral body height.
Both vertebral augmentation procedures take about a half hour per spinal level treated. The procedures are ultra-minimally invasive, and if performed outpatient at a surgery center or office procedure room, patients go home the same day. If performed at a hospital, patients generally go home the next day.
Most patients experience pain relief and improved mobility within 48 hours and, in some cases, immediately after surgery. Most patients can return to work a day or two later once the pain from the incisions has subsided. There are usually no physical restrictions after 72 hours, and the patient’s pain has been relieved.