Kyphoplasty/vertebroplasty is used to treat vertebral compression fractures that were caused by spinal tumors, a severe injury, or osteoporosis. During this minimally invasive surgery, bone cement is injected into the fractured vertebrae, allowing the vertebrae to return to their normal height. By restoring the affected area, the spine’s curvature is improved, and pain is relieved.
The spine is made up of strong bones called vertebrae, but they can break just like any other bone in the body. When they do, the result is called a vertebral compression fracture, because the main section of each vertebra collapses in height. Today doctors may recommend minimally invasive procedure specifically designed to treat spinal compression fractures.
The first is called “vertebroplasty.” during a vertebroplasty the doctor injects specially designed bone cement directly into the fractured vertebra through a small profile needle, to prevent it from collapsing any further and eliminate the motion within the bone due to fracture. This stops the severe pain. The vertebroplasty strengthens or casts the fractured bone.
The other minimally invasive procedure doctors may use today is called kyphoplasty. During a kyphoplasty, the procedure is essentially the same as vertebroplasty with the only difference being the placement of a balloon inside the fractured bone prior to cement injection. When the balloon is inflated, it creates a void or cavity within the vertebrae to aid in cement placement to fill the void and hold the fracture in place. Typically, patients will experience markedly reduced pain immediately following the procedure. These procedures are often per-¬ formed on an outpatient basis.
Procedure: The basic steps involved in Kyphoplasty/vertebroplasty include:
• The patient is placed on the operation table and sedated
• The affected segment of the spine is sterilized
• X-ray images are used to identify the placement of the incision
• A small incision is made and two large needles are inserted, at different angles, into the vertebral body through the pedicle; under fluoroscopic guidance
• An inflatable balloon is inserted, through one of the needles, into the compressed vertebrae and inflated to restore the normal height of the vertebrae
• Once the normal height of the vertebrae has been achieved, the balloon is deflated and withdrawn
• This procedure is called kyphoplasty, as it reduces abnormal curvature of the spine i.e. kyphosis, before stabilizing it
• The bone cement is filled into the prepared space
• The pressure and the quantity of the cement to be injected is monitored to prevent any leakage
• The needles are removed and the incision is closed and sutured
After the procedure most patients are observed for a day and discharged the next day. The basic post-operative instructions for the patients who undergo kyphoplasty/vertebroplasty include:
• Post-operative pain is managed by medications such as painkiller and narcotics
• Avoid any strain or stressful movement for the first 24 hours, then gradually resume your routine activities
• Maintain proper posture while sitting, standing, sleeping and lifting; in consultation with your physiotherapist
• Start physical therapy as and when recommended by your neurosurgeon
• Keep the incision clean and dry
Risks and complications
As there are few complications associated with every surgery. The complications associated with kyphoplasty/vertebroplasty include:
• The leakage of the bone cement that may cause compression or blockage of neural foramen and result in nerve pain
• Damage of the spinal nerves that may cause numbness or paralysis