Kyphoplasty/Vertebroplasty

What is Kyphoplasty?

Kyphoplasty is a medical procedure used to treat spinal compression fractures, particularly those caused by osteoporosis or cancer. During kyphoplasty, a surgeon inserts a balloon-like device into the fractured vertebra through a small incision. Once in place, the balloon is inflated to create space within the vertebra and to restore its height.

After the balloon is inflated, the surgeon injects bone cement into the cavity created by the balloon. This cement hardens quickly, stabilizing the fractured vertebra and providing support to the surrounding bone. By stabilizing the vertebra, kyphoplasty can help relieve pain, improve spinal alignment, and restore some lost mobility caused by the fracture.

Kyphoplasty is considered a minimally invasive procedure, meaning it typically requires only small incisions and has a shorter recovery time compared to traditional open surgery. It is often performed under local or general anesthesia, depending on the patient's needs and the complexity of the procedure.

What is Vertebroplasty?

Vertebroplasty is a minimally invasive surgical procedure used to treat vertebral compression fractures, particularly those caused by osteoporosis or cancer. It is similar to kyphoplasty but differs in technique and some aspects of the procedure.

Vertebroplasty aims to stabilize the fractured vertebra, reduce pain, and improve the patient's overall quality of life. It is considered a minimally invasive procedure, meaning it typically involves smaller incisions, less tissue damage, and quicker recovery times compared to traditional open surgery.

Vertebroplasty and kyphoplasty are similar procedures with some differences in technique and approach. In kyphoplasty, a balloon-like device is used to create space within the fractured vertebra before injecting the bone cement. This can help restore the height of the vertebra and correct deformities. However, in vertebroplasty, bone cement is injected directly into the fractured vertebra without prior balloon inflation. The choice between vertebroplasty and kyphoplasty depends on factors such as the nature of the fracture, the patient's overall health, and the preferences of the treating physician.

How do you qualify for the procedure?

Qualifying for kyphoplasty/vertebroplasty typically involves several factors, including the nature of the vertebral compression fracture and the patient's overall health. Here are some considerations:

Presence of vertebral compression fracture: Kyphoplasty is primarily used to treat vertebral compression fractures, which can result from conditions such as osteoporosis or cancer. Imaging tests, such as X-rays, CT scans, or MRIs, are used to confirm the presence of a fracture and assess its severity.
Symptoms: Kyphoplasty is often recommended for individuals who experience significant pain and disability due to the vertebral compression fracture. Common symptoms include back pain, limited mobility, and difficulty performing daily activities.
Failure of conservative treatments: Before considering kyphoplasty, patients may undergo conservative treatments such as pain medication, rest, physical therapy, and bracing. If these treatments fail to provide sufficient relief, kyphoplasty may be considered.
Overall health: The patient's overall health and medical history are important factors in determining their eligibility for kyphoplasty. Certain medical conditions or medications may increase the risks associated with the procedure. A thorough evaluation by a healthcare provider is necessary to assess the patient's suitability for surgery.
Bone density: In cases of osteoporotic fractures, the patient's bone density may also be evaluated to assess the risk of future fractures and determine the effectiveness of kyphoplasty in stabilizing the spine.

Ultimately, the decision to undergo kyphoplasty is made on a case-by-case basis by the patient and your physician, taking into account factors such as the severity of symptoms, the potential benefits and risks of the procedure, and the patient's overall health and preferences. It's essential to consult with a physician for personalized advice and recommendations regarding the procedure.

What is done during a kyphoplasty?

Preparation: The patient is typically positioned face down on an operating table. The area where the procedure will take place is cleaned and sterilized.
Anesthesia: Local or general anesthesia is administered to ensure the patient's comfort during the procedure. The choice of anesthesia depends on factors such as the patient's overall health and the surgeon's preference.
Guidance: Fluoroscopy, a type of real-time X-ray, is often used during the procedure to guide the surgeon's instruments to the precise location of the fracture.
Access: A small incision is made near the site of the fractured vertebra. Through this incision, the surgeon inserts a narrow tube called a cannula into the vertebra.
Balloon insertion: A special balloon-like device called a bone tamp or a balloon catheter is then inserted through the cannula and into the fractured vertebra. Once positioned correctly, the balloon is inflated gently to create a cavity within the vertebral body and to restore its height.
Cement injection: After the desired height restoration is achieved, the balloon is deflated and removed, leaving behind a cavity. Bone cement, typically made of a medical-grade acrylic material, is injected into this cavity under low pressure. The cement fills the cavity and hardens quickly, stabilizing the fractured vertebra.
Closure: Once the cement has hardened, the cannula is removed, and the small incision is closed with sutures or adhesive strips.
Recovery: After the procedure, patients are usually monitored for a short period in a recovery area before being discharged. Most patients can return home the same day. However, they may need to avoid certain activities for a short period while the cement fully hardens and the spine heals.

What is done during a vertebroplasty?

Preparation: The patient is typically positioned face down on an operating table. The area where the procedure will take place is cleaned and sterilized.
Anesthesia: Local anesthesia is often used to numb the area where the procedure will be performed. In some cases, sedation may also be administered to help the patient relax.
Guidance: Fluoroscopy, a type of real-time X-ray, is used to guide the surgeon's instruments to the precise location of the fracture.
Needle insertion: A small incision is made near the site of the fractured vertebra. Through this incision, a hollow needle is inserted into the fractured vertebra under fluoroscopic guidance.
Bone cement injection: Once the needle is in position, bone cement (usually a medical-grade acrylic material) is injected directly into the fractured vertebra. The cement fills the spaces within the fractured bone, stabilizing it and providing support.
Closure: After the cement has been injected, the needle is removed, and the small incision is closed with sutures or adhesive strips.

What is the recovery process like?

Immediate post-procedure: After the procedure, patients are typically monitored in a recovery area for a brief period to ensure there are no immediate complications. Most patients can expect to be discharged home on the same day as the procedure.
First few days: In the immediate aftermath of procedure, patients may experience some discomfort or soreness at the site of the incision. It's common for patients to need a day or two of rest to recover from the effects of anesthesia and to manage any post-operative pain. During this time, patients should avoid strenuous activities and heavy lifting.
First few weeks: Over the next few weeks, patients typically experience a gradual improvement in symptoms, including reduced back pain and increased mobility. While most patients can resume light activities and return to work within a week or two, it's important to avoid activities that could strain the spine or impede the healing process.
Restricted activities: Even as patients begin to resume their normal activities, there may be restrictions on certain activities, such as lifting heavy objects or participating in high-impact sports. These restrictions are typically in place for several weeks to allow the spine to heal properly.
Follow-up appointments: Patients will have follow-up appointments with their healthcare provider to monitor their progress and assess the effectiveness of the procedure. The frequency of these appointments may vary depending on the individual patient's recovery.
Return to normal activities: Many patients can resume their normal activities within a few weeks of the procedure, although individual recovery times may vary. However, it's essential to avoid activities that could put excessive strain on the spine until it has fully healed.