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Kyphoplasty

Kyphoplasty and Vertebroplasty1

Balloon Kyphoplasty

Balloon kyphoplasty is a spine surgery that relieves back pain caused by a vertebral compression fracture. Osteoporosis (bone disease) is the primary cause of vertebral compression fractures. Other causes include trauma such as a fall or motor vehicle accident, and some types of cancers affecting the spinal vertebrae. The aim of balloon kyphoplasty is to relieve pain, stabilize the fracture and restore the vertebral body height.

Your doctor recommends balloon kyphoplasty if you have severe pain and deformity that is not relieved by non-surgical treatment modes including rest, pain medications, and braces.

The surgery is performed under general anesthesia. During the procedure, you will lie face down on the operating table. A small incision is made in the back through which a narrow tube is inserted into the compressed vertebra under the guidance of live X-ray. Then a special balloon is inserted through this tube and carefully inflated. This elevates the fracture and restores the vertebra to its original height. The balloon is then deflated and removed leaving behind an open cavity. The cavity is filled with bone cement with the help of miniature surgical instruments. The cement hardens within a few minutes and stabilizes the bone.

You may experience significant pain relief following surgery and will be allowed to get up and walk. Your doctor will prescribe pain medication if necessary and recommend a rehabilitation program to strengthen your spinal muscles. You should avoid strenuous activities for at least 6 weeks.

As with any surgery, balloon kyphoplasty may be associated with certain complications which include infection, nerve or spinal cord injury and cement particles entering the blood or spinal fluid.

Vertebroplasty

Vertebroplasty and Kyphoplasty

Thoracic Vertebroplasty

Osteoporosis is a “silent” disease characterized by weakening of bones, making them more susceptible to fractures, typically in the hip and spine. Elderly people and especially post-menopausal women are at greater risk of developing osteoporosis.

The mid to lower back area of the spine is mainly involved in weight-bearing, making these regions of spine more prone to collapse when bone weakness is present. This can lead to spinal (vertebral) compression fractures in these patients. Many of these vertebral compression fractures occur by minimal trauma or by no trauma at all. They can even occur while doing simple activities, like bending or twisting. Symptoms range from severe pain in the back, arms and legs to no pain at all. Most patients suffering from such a fracture may believe that their back pain is just a part of ageing, letting these vertebral compression fractures go undiagnosed. However, a single vertebral fracture significantly increases a person’s risk of further fractures. When multiple fractures occur, it causes the spine to become rounded and bent forward resulting in loss of height and a hunchback appearance. This forward curvature of the spine negatively affects the quality of life of the patient and makes it more difficult for them to breathe, eat, walk, or sleep. Vertebral compression fractures can also occur in patients suffering from conditions such as metastatic tumor, multiple myeloma, and vertebral hemangioma.

Vertebroplasty is a minimally invasive procedure which is performed to reduce or eliminate pain caused by vertebral compression fracture. It stabilizes the fracture and prevents further collapse of the vertebra averting deformity. The vertebroplasty procedure involves injection of bone cement into the fractured vertebra under high pressure. The procedure is done under general or local anesthesia. You will be lying face down on the operating table. Your doctor will make a very small 1/2-inch incision in the skin over the fracture site. Under live X-ray guidance, a hollow needle called a trocar is introduced through the back and is positioned within the fractured vertebrae. Next, bone cement is injected into the area through the trocar under high pressure. After the vertebral body is filled completely with the bone cement, the needle is withdrawn before the cement hardens. X-rays or CT scans may be done to confirm the effective spread of the bone cement into the fractured vertebra. The skin incision is closed using steri-strips.

Contraindications

The procedure cannot be performed under the following situations:

  • Compression fracture is stable and does not cause any pain
  • A fractured fragment or tumor is present in the spinal canal
  • Presence of a bone infection or bleeding disorder

Risks and complications

As with any surgery, some risks can occur. General complications include bleeding, infection, blood clots and reactions to anesthesia. The specific complications following a thoracic vertebroplasty include leakage of the bone cement into surrounding soft tissues or veins and damage to the spinal cord or spinal nerves leading to numbness or paralysis.