What Are Kyphoplasty & Vertebroplasty?
Vertebroplasty and Kyphoplasty
These are minimally invasive procedures for the treatment of painful vertebral compression fractures (VCF), which are fractures involving the vertebral bodies that make up the spinal column. When a vertebral body fractures, the usual rectangular shape of the bone becomes triangular/compressed, causing pain. These compression fractures may involve the collapse of one or more vertebrae in the spine and are a common result of osteoporosis.
Osteoporosis is a disease that results in a loss of normal bone density, mass, and strength, leading to a condition in which bones become increasingly porous and vulnerable to breaking easily. Vertebrae may also become weakened by cancer.
During kyphoplasty, a balloon is first inserted into the fractured bone through the hollow needle to create a cavity or space. The cement is injected into the cavity once the balloon is removed.
Vertebroplasty is an outpatient procedure for stabilizing compression fractures in the spine. For vertebroplasty, physicians use image guidance, typically fluoroscopy, to inject a cement mixture into the fractured bone through a hollow needle. Bone cement is injected into back bones (vertebrae) that have cracked or broken, often because of osteoporosis. The cement hardens, stabilizing the fractures and supporting your spine.
For people with severe, disabling pain caused by a compression fracture, vertebroplasty can relieve pain, increase mobility, and reduce the use of pain medication.
Both processes are minimally invasive and involve injecting cement into the fractured bone to stabilize it, which can help reduce pain and improve mobility. Another way to think of your spine as a multi-floored building with each floor as vertebrae. If one floor starts to crumble, it affects all the other floors; they start to lean, compromising the elevator (spinal cord) in its ability to go to the top floor!
Kyphosis, or forward curvature of the spine, can be caused by various factors, including age-related changes in bone density, trauma, tumors, infection, metabolic disorders such as hyperparathyroidism, disease, multiple myeloma, and other conditions.
What Are the Differences Between Kyphoplasty And Vertebroplasty?
Kyphoplasty and Vertebroplasty can modify the spine by using the pressure and space created by the cement balloon to adjust a shifted spine, support a collapsing spine, or realign the spine. Depending on the extent of the procedure they can be performed under either general anesthesia or local anesthesia.
- In vertebroplasty, a needle is inserted through an incision in your back and into the fracture area. Then, a unique tool called a trocar injects a small amount of bone cement directly into the broken bone. The doctor will use image guidance to inject a cement mixture into the fractured bone through a hollow needle
- In kyphoplasty, A balloon is first inserted to create a cavity or space in the fractured bone with a hollow needle. Next, the balloon is inflated, which pushes out the surrounding material and creates a cavity inside the bone. This cavity can be filled with bone cement or other materials that help stabilize the spine. Balloon Kyphoplasty can restore a damaged vertebra’s height and may also relieve pain. Like vertebroplasty, kyphoplasty injects special bone cement into your vertebrae — creating space for the treatment with a balloon-like device.
Dr. Cyr and the SA Spine clinicians will discuss your situation’s risks and benefits. For example, kyphoplasty might be recommended for cancer-damaged vertebrae or pathological fractures. Usually, a weakening of the bones (osteoporosis) causes the vertebrae to compress or collapse, causing pain or misalignment.
Kyphoplasty and Vertebroplasty procedures are both highly successful and safe.
More About Kyphoplasty and Vertebroplasty Surgery
The goals of these surgical procedures are designed to:
- Stop the pain caused by a spinal vertebral fracture
- Stabilize the bone
- Restore some or all of the lost vertebral body height due to the compression fracture
These balloon procedures have revolutionized vertebral compression fracture surgery in the last 20 years, and innovations continue. Kyphoplasty and Vertebroplasty are an effective treatment option for patients with painful osteoporotic vertebrae that are unstable enough to cause back pain and/or deformity and poor quality of life.
Why Are Kyphoplasty and Vertebroplasty Performed – Causes
The most common type of compression fracture is a vertebral body fracture (also called a burst fracture). This occurs when one side of a bone breaks off from the main part of the bone. It usually happens in the lower back but can appear along the spinal column. A compression fracture causes pain and loss of height because the broken pieces of bone push on the spinal cord and nerves that run through your spine.
When a vertebral body fractures, the rectangular shape of the bone becomes compressed, causing severe pain. These vertebral compression fractures may involve the collapse of one or more vertebrae in the spine and are a typical result of osteoporosis. Patients with osteoporosis likely lose normal bone density, mass, and strength, leading to a condition in which bones become increasingly porous and susceptible to osteoporotic fractures. Vertebrae may also become weakened by cancer and metastatic disease.
The fractured vertebra in the spine can be caused by thinning of your bones or osteoporosis. This procedure may be recommended if you have severe and disabling pain that has no relief with conservative treatments of bed rest, pain medications, or physical therapy for more than two months.
The most common type of osteoporotic fracture is a vertebral body fracture (also called a compression fracture). This occurs when the part of a bone collapses. It usually happens in the lower back but can appear along the spinal column. Sometimes the back part of the bone breaks and pushes back into the spinal canal where the nerves are. This type of fracture is called a burst fracture. It causes pain and loss of height and can damage the nerves and spinal cord because the broken pieces of bone push on the spinal cord and nerves that run behind the vertebral bones.
Osteoporosis
Osteoporosis means “porous bones.” Osteoporosis is a disease that causes bones to become thin and brittle. The condition weakens the bones causing osteoporotic compression fractures. Bones may also be compromised, causing nerve damage.
Causes include:
- Age
- Injury
- Having a family history
- Certain medications, anticoagulants for example
- Being a Caucasian or Asian woman
- Cancer, including multiple myeloma
A person with a compression fracture will have severe pain in the affected area. The pain may feel like a sharp, stabbing sensation or dull and throbbing. Pain can also occur if you move your arm or leg. In addition, you may notice swelling around the injury. If you experience any of these symptoms, see your doctor right away.
Compression Fractures
Compression fractures are caused by a crack in the vertebrae. The vertebrae collapse as a result of compression fractures, shortening them in height. Moreover, this collapse may result in bone fragments pressing against the spinal cord and nerves, reducing the amount of blood and oxygen reaching the spinal cord.
This type of fracture is common among older adults. It can occur in the spine, pelvis, or ribs. Compression fractures usually result from osteoporosis and other conditions that weaken the bones. but can caused by trauma such as a fall or car or motorcycle accident.
Are You A Candidate For Kyphoplasty or Vertebroplasty Procedures?
Candidates for these procedures often have a reduced ability to move and function due to fractures or specific bone degenerating cancers.
Kyphoplasty or Vertebroplasty surgery is not recommended for disk herniations, arthritis, stenosis (narrowing), or spinal cord compression. X-rays, bone scans, CT, MRI, or DXA (dual-energy x-ray absorptiometry scan, these radiological outcomes can confirm if you will benefit from this procedure or if a different procedure such as a Laminectomy or Corpectomy is needed.
Once your surgeon has evaluated your health and imaging, they will recommend the best procedure to correct your spine pain.
Before Surgery
Dr. Cyr will make his best effort to stay minimally invasive with a small cut or puncture in your back. Vertebroplasty and kyphoplasty are less invasive than other procedures and generally have a quicker recovery rate, which offers postoperative pain relief sooner.
You will discuss your health, medications, previous surgeries, imaging, and smoking habits with Dr. Cyr and his team to ensure your safety and achieve the very best outcome.
However, if you require a more extensive procedure like spinal fusion surgery, it takes longer to heal but the goal of the outcome is the same – reduce pain and improve quality of life.
Recovery From Spinal Compression Fracture Surgery
First, you should ensure that you are in the best possible condition before your surgery. You can start by doing mild exercises, such as stretching, walking, swimming, and cycling, if recommended by your doctor. Many patients are unable to be active or even sit up or get out of bed secondary to pain. If that happens, it is important not to delay seeing a spine surgeon. Movement after surgery helps you recover faster from the surgery, but aggressive exercise should be delayed until you are fully recovered.
Postoperative pain relief and returning to a routine is our goal after surgery for a spinal compression fracture or osteoporotic fracture. Many factors depend on the type of operation you have. Dr. Cyr and the SASpine Team will advise you and give guidelines to give you the best possible postoperative improvement.
You can expect to have limited activities for a period prescribed by your surgeon, and they may suggest physical therapy to improve healing and enhance your results.
If it’s time to consider Kyphoplasty or Vertebroplasty, contact SA Spine for your initial appointment and begin the journey to pain relief.
