Kyphoplasty and Vertebroplasty
Kyphoplasty and vertebroplasty are minimally invasive surgical procedures used to treat compression fractures of the spinal vertebrae, the bones that make up the spine.
These procedures can help relieve pain resulting from spinal compression and are often recommended for patients who are unable to tolerate open spinal surgery, particularly the elderly or those with autoimmune disorders.
As many as 75 percent of patients receiving these procedures get relief from pain and regain lost mobility.
Kyphoplasty is performed on patients who experience vertebral compression fractures resulting from osteoporosis.
During the procedure, a balloon tamp is inserted into the fractured vertebra and inflated. By creating a space where the fractured bone was and may restore the vertebra to its proper height and shape. The balloon is then removed and special cement is inserted into the space created by the balloon.
Vertebroplasty is performed on patients with back pain, for whom nonsurgical treatments have proven ineffective. It may also be performed on patients suffering from severe back pain that requires hospitalization.
In vertebroplasty, a physician injects a special cement through a needle into the fractured bone.
Both procedures are minimally invasive outpatient surgeries, and can be performed in about an hour. Following surgery, bed rest is recommended for the first 24 hours. In time, light activity may be resumed, although strenuous exertion is to be avoided for at least six weeks after surgery.
For many patients, pain relief will be immediate in the wake of these procedures; in others, it may take a few weeks to feel relief. There may also be some pain at the point of needle insertion, but your physician will give you pain medicine to help with post-operative discomfort.
Due to the minimally invasive nature of these procedures, complications are limited but could include:
- Infection: Because the procedure involved puncturing the skin, there is a slight risk of infection.
- Cement leakage: A small amount of cement can leak from the vertebra, though this complication is rare.
- Numbness, tingling, paralysis: Though rare, some injury to spinal nerves may occur, causing adverse reactions.
- Allergy: Some patients may be allergic to materials used in the procedure.
More about the procedures
These procedures are usually performed by specially-trained neuroradiologists or interventional radiologists, who use radiographic tables and fluoroscopes to track their progress as they operate.
Both procedures also use a medical cement with the key ingredient polymethylacrylate (PMMA). A needle called a trocar is used to penetrate the spinal bone and administer the cement, which usually hardens within 20 minutes.
Both procedures use the posterior (back) approach, while you to lay face-down. The surgeon uses detailed imaging to help guide the trocar through the spinal muscles until it is positioned in the fractured vertebra, then injects the cement.
A CT scan may be performed at the end of either procedure to make sure the cement is evenly distributed.