Kyphoplasty is a minimally invasive procedures used to treat the fractures of the spine. These painful, wedge-shaped fractures can be caused by osteoporosis and injury. Left untreated, they can lead to a humped spine (kyphosis). By restoring the vertebra height with a balloon and injecting cement into the fractured bone, patients can recover faster and reduce the risk of future fractures.
People with bones weakened by osteoporosis (a depletion of calcium) or multiple myeloma (cancer of the bone marrow) are especially prone to spine fractures. Activities, such as lifting a heavy object, sneezing or coughing may cause fractures. Fractures can lead to back pain, reduced physical activity, depression, loss of independence, decreased lung capacity, difficulty in sleeping and turning in bed.
In kyphoplasty, a balloon is first inserted and inflated to expand the compressed vertebra to its normal height before filling the space with bone cement. The procedures are repeated for each affected vertebra. The cement-strengthened vertebra allows you to stand straight, reduces your pain, and prevents further fractures.
Without treatment, the fractures will eventually heal, but in a collapsed position and strict bedrest for atleast 8-12 weeks is required. The benefit of kyphoplasty is that your vertebra is returned to normal position before the bone hardens. Patients who've had kyphoplasty report significantly less pain after treatment and they can walk and sit immediately after procedure.
Studies show that people who get one osteoporotic fracture are 5 times more likely to develop additional fractures. It is important that people seek treatment for osteoporosis early, before fractures occur.
Who is a candidate?
Kyphoplasty may be a treatment option if you have painful vertebral compression fractures from:
Osteoporosis (a depletion of calcium in bones)
Metastatic tumor (cancer spread from another area)
Multiple myeloma (cancer of the bone marrow)
Vertebral hemangioma (benign vascular tumor)
You may not be a candidate if you have:
Non-painful stable compression fractures
Bone infection (osteomyelitis)
Allergy to medications used during the procedure
Fracture fragment or tumor in the spinal canal
Kyphoplasty will not improve old and chronic fractures, nor will they reduce back pain associated with poor posture and stooping forward. Traditional treatment used to involve waiting 4 to 6 weeks to see if patients improved on their own, but now it's believed that waiting allows the bone to harden, making kyphoplasty less effective.
Patients are admitted to the hospital the morning of the procedure. No food or drink is permitted past midnight the night before surgery. An intravenous (IV) line is placed in your arm. To minimize pain and discomfort, you will be given either general anesthesia, which puts you to sleep, or conscious sedation. Under conscious sedation you are awake, but feel no pain and may have no memory of the procedure.
What happens after surgery?
You will return to the recovery area. Your blood pressure, heart rate, and respiration will be monitored, and your pain will be addressed. You'll remain lying down for the first hour after the procedure. After 1 hour you may sit up. After 2 hours you may get up and walk. Most patients stay in the hospital overnight for observation and are released the next morning. Some patients can be released home the same day.
What are the results?
The sooner a fracture is repaired, the better the results. Kyphoplasty relieves pain in 75-90% of patients. This reduction in pain and increased ability to move significantly improved the patients' quality of life. Other studies in cancer patients with multiple myeloma have shown similar results.
What are the risks?
No surgery is without risks. General complications of any surgery include bleeding, infection, blood clots, and reactions to anesthesia. Complications in the treatment of vertebral compression fractures is less than 2%, and 5 to 10% in the treatment of tumors. The following are specific risks that should be considered:
Bone cement leakage. There is a slight possibility that bone cement can leak along the outside of the needle into surrounding soft tissues. This can also happen when the needle is removed from the vertebra. Cement can leak into the veins surrounding the vertebra. The surgeon closely watches the fluoroscope and stops injecting cement if this begins to happen. Cement can leak into the neural foramen where the spinal nerve exits the spinal cord. This can cause nerve pain (radiculopathy) and may require further treatment.
Nerve damage. Any operation on the spine comes with the risk of damaging the spinal nerves or cord, which can cause numbness or paralysis.