Both kyphoplasty and vertebroplasty are minimally invasive procedures used to treat the pain associated with a vertebral compression fracture (VCF). Osteoporosis affects around 28 million Americans, and this condition causes the bones to become weakened and brittle. Osteoporosis, bone tumors, and malignancy all are causes of VCF.
How common are VCFs?
VCFs affect around 25% of all postmenopausal women in the U.S. This rate increases to 40% for women over 80 years of age. The rate of occurrence for a new vertebral compression fracture is 15% following a vertebroplasty or kyphoplasty procedure.
Who is a candidate for vertebroplasty and kyphoplasty?
These bone-stabilizing procedures are used to strengthen collapsed vertebrae and restore bone height. Because success rates drop the longer the fracture is present without treatment, kyphoplasty and vertebroplasty are most effective when done within a few weeks of the fracture.
How do I prepare for the kyphoplasty or vertebroplasty procedure?
Prior to the procedure, the doctor will discuss the benefits and complications with you. You should notify the doctor of all medications you are taking. Because bleeding is a risk, you may have to hold certain blood-thinning agents for several days before the procedure. You need to bring someone with you to drive you home, unless you are to be staying overnight. When you arrive, a nurse has you change into a gown and places an IV in your arm to administer medications and fluids.
How is vertebroplasty peformed?
With vertebroplasty, the patient is sedated, but awake. After being positioned face down on a procedure table, the back is numbed with an anesthetic. A small needle cannula is inserted into the vertebra using x-ray guidance for correct placement. Bone cement is injected using direct pressure into the fractured bone. Once this is done, it takes around 10 minutes for the cement to harden. There is no manipulation of the vertebra during this procedure.
How is kyphoplasty different than vertebroplasty?
With kyphoplasty, the patient is positioned on the stomach and the skin is numbed, as with vertebroplasty. Kyphoplasty involves making a small incision over the collapsed vertebra and insertion of a special balloon needle. Once the needle is near the fracture, the balloon is inflated to restore the collapsed vertebra to original height. The cement is injected to fill the space and hold the bone in place.
When is kyphoplasty superior to vertebroplasty?
Kyphoplasty is used when there is a severe collapse of the fractured vertebra or wedging occurs (front of the spine tilts). This prevents severe kyphotic (humpback) spinal deformities.
What happens after the procedure?
After the procedure, a nurse will monitor your condition and ask you questions about your pain. You will remain in the lying position for around 30 minutes. Some patients are required to stay overnight for observation, depending on underlying medical issues and pain status after the procedure. Once you are stable, you will be given discharge instructions and a follow-up appointment.
What complications are associated with these procedures?
Even though risks are rare, there are a few complications to consider. These include leakage of bone cement out of the vertebra, infection, damage to nerves, blood vessel injury, and pulmonary embolism (blood clot in lung). Because the bone cement is thin, it could possible leak into the veins around the spine, but this rarely occurs.
How effective are kyphoplasty and vertebroplasty?
For these procedures, the efficacy rate for pain relief is around 90%. In addition, both kyphoplasty and vertebroplasty are associated with low morbidity rates.