Vertebroplasty and Kyphoplasty

Overview

Vertebroplasty and Kyphoplasty are procedures used to treat vertebral body compression fractures, which are small cracks in the dense mass of bone that forms the front of your spinal column (the vertebral body). Vertebroplasty involves the percutaneous injection of bone cement into the cancellous bone of a vertebral body for the purposes of relieving pain and preventing further height loss of the vertebral body. Kyphoplasty employs an inflatable balloon to create a cavity for the cement, with the potential additional goals of restoring height and minimizing kyphosis. Vertebroplasty was first introduced in 1987 to successfully treat painful vertebral angiomas in patients. Since then, the treatment of osteoporotic compression fractures, traumatic compression fractures, and metastatic compression fractures has been expanded to include vertebroplasty. The most prevalent indication for this procedure is now osteoporotic compression fractures. Later, kyphoplasty was developed as an adaptation of vertebroplasty in which a balloon tamp is inflated within the vertebral body to compress the cancellous bone and create a cavity.

Diseases treated with Vertebroplasty and Kyphoplasty

Vertebroplasty or kyphoplasty could be an option for treating painful vertebral compression fractures caused by:

Osteoporosis (a depletion of calcium in bones) (a depletion of calcium in bones)
Metastatic tumor (cancer spread from another area)
Multiple myeloma (cancer of the bone marrow)
Vertebral hemangioma (benign vascular tumor)

To be a candidate for kyphoplasty/vertebroplasty, the patient’s pain must be caused by the vertebral fracture and not by other conditions such as disk herniation, arthritis, or stenosis (narrowing). To confirm the presence of a vertebral fracture, imaging tests such as spinal x-rays, bone scans, computed tomography (CT) or magnetic resonance imaging (MRI) scans may be ordered. Your healthcare provider may order a dual energy x-ray absorptiometry (DXA) scan if you have osteoporosis.

Preparation for Vertebroplasty and Kyphoplasty

Several days prior to surgery, preoperative tests (e.g., blood test, electrocardiogram, chest X-ray) may be necessary. Consult your primary care physician regarding the discontinuation of certain medications and ensure that you are surgically cleared. Don’t eat or drink after midnight before surgery (unless the hospital tells you otherwise). You are permitted to take permitted medications with a small sip of water.

Typically, patients are admitted to the hospital the morning of their surgery. You will receive either general anesthesia, which induces sleep, or conscious sedation to reduce pain and discomfort. Under conscious sedation, the patient is awake, but does not feel pain and may not remember the procedure.

Vertebroplasty and Kyphoplasty Procedure

You will lie on your stomach throughout the kyphoplasty/vertebroplasty procedure. A healthcare provider will insert a trocar, which is a hollow needle, through the skin and into the vertebra. The proper placement of the trocar is determined using fluoroscopy, a form of x-ray imaging.

Once the trocar is in place, either cement (vertebroplasty) or a balloon-like device (kyphoplasty) is inserted through the trocar into the vertebra. As the balloon is inflated during kyphoplasty, a space is created to be filled with bone cement.

The tiny incision in the skin is closed with skin glue or steri-strips. You will remain on the operating table until the remainder of the cement in the mixing bowl has hardened. You will return to the area for recovery. You will have your blood pressure, heart rate, and respiration monitored, and your pain will be treated. You will remain prone for the first hour following the procedure. After one hour, you can stand up. After two hours, you are permitted to walk. The majority of patients who are hospitalized for observation are discharged the following morning. Some patients are eligible for same-day discharge. Maintain the bandage for two days. Take showers rather than baths. Follow any additional instructions provided by your doctors.

Benefits of Vertebroplasty and Kyphoplasty

Within 48 hours of the procedure, kyphoplasty and vertebroplasty typically provides pain relief and improved mobility (movement). In certain instances, however, you may experience immediate pain relief. Seventy-five percent of patients are able to resume normal activity after vertebroplasty. You may be free of symptoms and not require physical therapy or rehabilitation.

Best Hospitals for Vertebroplasty and Kyphoplasty

Based on your condition, requirements, and, in some cases, genetics, our network of specialists can offer you a variety of treatments for spine surgery. Together, they will select a course of treatment that ensures you receive the therapy with the highest success rate and fewest side effects.