Kyphoplasty: A Detailed Explanation
What Is Kyphoplasty?
Kyphoplasty is a minimally invasive procedure used to treat painful vertebral compression fractures (VCFs) in the spine. The procedure helps stabilize the fractured vertebra, restore vertebral height, and relieve pain by injecting bone cement into the affected vertebra. It is commonly used for fractures caused by osteoporosis, cancer, or trauma.
What Are Vertebral Compression Fractures (VCFs)?
Vertebral compression fractures (VCFs) occur when a vertebra collapses due to weakened bone structure. This leads to severe back pain, spinal deformity, and reduced mobility.
Common Causes of VCFs:
- Osteoporosis (most common cause)
- Trauma or injury
- Spinal tumors or metastases
- Long-term corticosteroid use (weakens bones)
- Degenerative bone diseases
Symptoms of Vertebral Compression Fractures:
- Severe back pain (sudden or chronic)
- Loss of height
- Hunched posture (kyphosis)
- Limited mobility
- Pain that worsens with movement and improves when lying down
How Does Kyphoplasty Work?
Kyphoplasty involves inflating a small balloon inside the fractured vertebra to create space, followed by the injection of bone cement to restore height and stability.
Step-by-Step Kyphoplasty Procedure
- Pre-Procedure Evaluation:
- Medical history and physical examination.
- X-rays, CT scans, or MRI to confirm vertebral fractures.
- Bone density tests if osteoporosis is suspected.
- Preparation:
- The procedure is performed under local anesthesia with sedation or general anesthesia.
- The patient lies face-down on the procedure table.
- Balloon Inflation:
- A small incision (less than 1 cm) is made in the back.
- A hollow needle (trocar) is inserted into the fractured vertebra using fluoroscopy (X-ray guidance).
- A small balloon catheter is placed inside the vertebra and inflated to create space and restore height.
- Bone Cement Injection:
- The balloon is deflated and removed.
- A special bone cement (polymethyl methacrylate – PMMA) is injected into the space to stabilize the vertebra.
- The cement hardens in minutes, providing immediate structural support.
- Completion:
- The needle is removed, and the incision is covered with a bandage (no stitches needed).
- The entire procedure takes about 30-60 minutes per vertebra.
Who Is a Candidate for Kyphoplasty?
Kyphoplasty is recommended for patients who:
- Have painful vertebral compression fractures due to osteoporosis or cancer.
- Experience severe, persistent back pain that does not improve with medications or physical therapy.
- Have fractures that significantly impact mobility or posture.
- Do not have spinal cord compression or infection.
Benefits of Kyphoplasty
- Immediate pain relief (within 24-48 hours for most patients).
- Restores vertebral height (reducing spinal deformity).
- Minimally invasive (small incision, no stitches).
- Short procedure time (30-60 minutes per vertebra).
- Faster recovery (return to daily activities within days).
- Reduces risk of further fractures by stabilizing the spine.
Risks and Complications
Kyphoplasty is generally safe, but potential risks include:
- Infection (rare)
- Bleeding or bruising at the incision site
- Allergic reaction to anesthesia or bone cement
- Cement leakage (can irritate nearby nerves but is uncommon)
- Fractures in adjacent vertebrae (due to increased stress on nearby bones)
Recovery and Post-Procedure Care
- Same-day discharge (most patients go home the same day).
- Light activity can be resumed within 24-48 hours.
- Avoid heavy lifting or strenuous activities for a few weeks.
- Physical therapy or bone-strengthening treatments may be recommended to prevent future fractures.
- Follow-up imaging may be done to check cement placement.
Kyphoplasty vs. Vertebroplasty
Kyphoplasty is often compared to vertebroplasty, another minimally invasive spinal procedure. The key difference is that kyphoplasty uses a balloon to restore height before injecting cement, whereas vertebroplasty injects cement directly without height restoration.
| Feature | Kyphoplasty | Vertebroplasty |
|---|---|---|
| Balloon inflation before cement injection | ✅ Yes | ❌ No |
| Restores vertebral height | ✅ Yes | ❌ No |
| Cement leakage risk | Lower | Higher |
| Pain relief effectiveness | High | High |
| Procedure time | 30-60 minutes | 20-30 minutes |
Conclusion
Kyphoplasty is a highly effective, minimally invasive procedure for treating vertebral compression fractures. It provides rapid pain relief, restores spinal height, and improves mobility with minimal risks. If you’re experiencing persistent back pain due to osteoporosis or a spinal fracture, kyphoplasty may be a suitable option.
