What Is a Kyphoplasty and a Vertebroplasty?
Kyphoplasties and vertebroplasties are minimally invasive spine surgical procedures that treat spinal compression fractures. Both procedures use bone cement to reinforce weakened vertebrae (backbones). The biggest difference is in a vertebroplasty the cement is injected directly into the vertebrae, whereas in a kyphoplasty a special balloon is first inserted and inflated before the bone cement is added to restore the vertebra to its original height.
Common Reasons for Kyphoplasty and Vertebroplasty
A vertebral compression fracture is the most common reason to have a kyphoplasty or a vertebroplasty. Vertebral compression fractures occur when vertebrae crack. Sometimes they collapse onto the vertebra below it, causing back pain that is due to nerve compression.
People with osteoporosis are at a greater risk of vertebral compression fractures. Osteoporosis is a condition in which bone mass is lost faster than the body can create it. This results in weak, brittle bones at risk for fracture.
People with severe osteoporosis are at risk of a vertebral compression fracture just by doing everyday activities such as lifting light objects or even coughing. It takes more force, such as a fall or lifting a heavy object, to put someone with mild or moderate osteoporosis at risk of a compression fracture. People with healthy bones generally develop compression fractures in only high-energy trauma events, such as car accidents or falls from greater than standing height.
Other diseases can cause compression fractures, but these are much more rare than osteoporotic compression fracture. Compression fractures caused by health conditions are known as pathological compression fractures. Myeloma, a cancer of the blood, is one such source of less common pathological compression fractures. Myeloma interferes with the body’s ability to produce new bone tissue. Myeloma affects the spines of up to 60 percent of patients at diagnosis.
An increase in the risk of early death in older people is associated with vertebral compression fractures due to, researchers believe, the deconditioning effect from pain and disability compression fractures cause. A January 2019 study published in Neurosurgery suggests that kyphoplasties and vertebroplasties are more effective in preventing early deaths associated with compression fractures than nonsurgical treatment.
Candidates
Candidates for kyphoplasty or vertebroplasty are affected by osteoporosis or myeloma and have experienced a vertebral compression fracture. The fracture must have caused the vertebra to lose height (collapse), and the patient must have tried more conservative treatment without success. Such conservative treatments can include:
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Back braces
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Muscle relaxing medications
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Pain-killing medications
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Rest
People who have blood clotting disorders such as hemophilia are not considered candidates for kyphoplasty or vertebroplasty because of the bleeding risk associated with general surgery.
How the Procedures Are Performed
Both kyphoplasties and vertebroplasties are minimally invasive procedures. The bone cement is injected with a needle, so there is no incision necessary. Doctors use continuous X-rays to visualize which vertebra has the fracture and where the needle must go.
Both procedures can be done with either a local or a general anesthesia. A general anesthesia means the patient is asleep for the procedure, whereas a local anesthesia blocks pain to the area but the patient is still conscious.
Kyphoplasties and vertebroplasties are both fairly brief procedures. Bone cement hardens in about 10 minutes, and the procedures usually take about an hour total (longer if more than one vertebra is being treated).
During the procedure, patients lay face down while the doctor uses an X-ray to ensure the right vertebra is targeted. The patient will be protected from the X-ray’s radiation.
Then the doctor inserts a needle into the vertebra. In a vertebroplasty, the needle is full of bone cement, which is injected into the fractured vertebra. During a kyphoplasty, a balloon is injected through the needle and then inflated, creating a hollow space that is then filled with bone cement.
Recovery
Kyphoplasties and vertebroplasties are usually outpatient procedures, meaning the patient can leave the hospital or surgery center within 24 hours after the surgery. There may be some discomfort or back pain, but most people can start walking almost immediately after the procedure.
Evidence suggests that kyphoplasties and vertebroplasties are effective procedures in relieving pain due to compression fractures. One review of scientific literature examined 69 studies, with a total of about 6,000 procedures. It suggests that 87 percent of people who had vertebroplasties and 92 percent who had kyphoplasties experienced pain relief.
Some people feel a reduction in pain immediately after the surgery, whereas in others it can take up to 48 hours. Most patients can resume light activity right away, but many doctors advise waiting up to six weeks before resuming strenuous activity such as heavy lifting.
If you have back pain, osteoporosis or myeloma and suspect you have experienced a vertebral compression fracture, request an appointment with a Summit Health Orthopedics spine specialist. Our experts can diagnose the source of your back pain and devise a treatment plan that’s right for you and your lifestyle.
To learn more about vertebral compression fractures or to find out if a kyphoplasty or vertebroplasty is right for you, follow the link below and answer a few short questions. Someone will get back to you as soon as possible. Thank you for choosing Summit Health.