Treatments: Kyphoplasty
Kyphoplasty
Overview
A compression fracture or a break in one of your vertebra can be painful. It can also make it difficult to move freely. That’s because a break can result in bone fragments rubbing against each other.
Surgery can help treat such fractures. For example, kyphoplasty and vertebroplasty are minimally invasive procedures that are often performed together. Usually, they can be done without a hospital stay.
In vertebroplasty, a doctor injects a cement mixture into the bone to give it strength.
Kyphoplasty makes room for the mixture. In this procedure, a doctor inserts and inflates a balloon to create an opening for the mixture. The balloon is removed after the cement is injected. Kyphoplasty is sometimes referred to as balloon vertebroplasty.
Both of these procedures are more likely to be successful if done within two months of a fracture diagnosis. They can help relieve pain and improve mobility when other measures fail to provide relief.
Candidates for kyphoplasty
These procedures can be effective in treating people whose bones are weakened by cancer or whose vertebrae collapse due to osteoporosis, a disease that causes loss of bone density.
Kyphoplasty and vertebroplasty are used to mend recent fractures. However, they aren’t used as a preventive technique, even for osteoporosis. As well, they’re usually not advised for herniated disks, back arthritis or curvature of the spine due to scoliosis.
These two procedures haven’t been extensively tested in younger, otherwise healthy people. The long-term effects of the bone cement aren’t known, so these procedures are generally reserved for older people.
What happens before and during the procedures
Preparation
Because kyphoplasty and vertebroplasty are surgical procedures, your doctor will probably order some blood tests before the day of your surgery. Imaging tests such as an x-ray or MRI scan will help your surgeon see the area or areas that need repair.
In preparation, an intravenous line (IV) will be placed in a vein in your arm to deliver anesthesia. You may also receive pain and anti-nausea medications, as well as antibiotics to prevent infection. You’ll probably also be connected to heart, pulse, and blood pressure monitors.
Procedures
For these procedures, you need to lie down on your stomach. The area in which the needle will be inserted is shaved if necessary and then cleaned and sterilized. A local anesthetic may be injected in the same place.
Your surgeon then performs these steps:
- The surgeon inserts a hollow needle (trocar) into your skin. With the aid of fluoroscopy, a type of X-ray, they guide the needle through your muscles and into the correct position in your bone.
- They next insert an inflatable balloon into the trocar.
- The balloon is then inflated to create the space needed for the bone cement.
- Once the space has opened up, the mixture is injected to fill it up. Imaging tests will help the surgeon confirm that the mixture is distributed properly.
- Once the cement is in place, the needle is removed.
- The area is bandaged. Stitches won’t be necessary.
- Your IV and monitoring equipment are removed.
If only one vertebra is being treated, kyphoplasty usually takes less than an hour.
Recovery after the procedure
Following the procedure, you’ll probably stay in a recovery room for a short time. You may be encouraged to get up and walk within an hour of the procedure. Some soreness is to be expected.
You may be able to go home later that day. However, you might need to stay in the hospital overnight for monitoring if:
- your procedure involves more than one vertebra
- there were any complications
- your general health isn’t good
Your doctor will advise you when you can resume normal activities and if you should take any bone-strengthening supplements or medications. You’ll probably be asked to schedule a follow-up visit to check your progress.
An ice pack can help relieve immediate soreness or pain, but you should be feeling better within 48 hours
Complications and Risks
All medical procedures have some level of risk. There’s a chance of infection or bleeding where the needle penetrated your skin. In some cases, nerve damage can lead to numbness, weakness, or tingling. It’s possible to have an allergic reaction to the materials used in the procedure.
