Kyphoplasty and Vertebroplasty

Kyphoplasty

Balloon kyphoplasty is a minimally invasive surgical technique to treat vertebral compression fractures caused by osteoporosis, spinal injury or cancer.

How Do I Know I Have A Fracture?

Osteoporosis is a debilitating bone disease that results in a reduction of bone mass predisposing the patient to an increased risk of vertebral and other fractures. Of all the fractures vertebral compression fractures (insufficiency fractures) are the most common but the least treated in the past.

If you experience sudden acute pain in your back after a minor fall or other minor incident (lifting heavy weight, jumping) consult your doctor and ask him to take an x-ray of your spine. The best way, however, to diagnose a fresh fracture of the spine is to do a MRI study with STIR weighted images. It is important to do this sooner than later because the fracture can become untreatable quickly.


Kyphoplasty Objectives

  • Take away the pain caused by the fracture.
  • Internally splint the fracture.
  • Prevent deformity or to restore deformity depending on the age of the fracture.
  • Increase mobility and preventing more bone loss caused by bed rest.
  • Prevent the use of pain and anti-inflammatory medications and the use of external splints.

A needle is passed into the fractured vertebra

Inflatable balloons are passed inside the vertebral body

How Is Kyphoplasty Done?

Kyphoplasty is done under a light general anaesthesia. Under sterile conditions and with x-ray positioning in place, a guide pin is passed through skin into the fractured vertebral body on both sides. After several more steps to ensure correct placement of the working channels two inflatable balloons is passed inside the vertebral body into the fracture. The balloons are slowly inflated to try and restore height loss caused by the fracture and also to create a bone void.

The balloons are then removed and through the same working channels bone cement is introduced in the void created by the balloons. The cement is introduced slowly and in a low flow state so that the surgeon has control over the flow of the cement. The instruments are removed and dressings applied. The procedure takes 30-60 minutes per level. After surgery the patient may sit and walk with no support and usually leaves the hospital the same day or next morning. If you develop severe pain any time after surgery you have a new fracture until proven otherwise.


Vertebroplasty

Vertebroplasty is a minimally invasive, non-surgical procedure that is designed to relieve the pain of compression fractures. Vertebroplasty literally means fixing the vertebral body. In addition to relieving pain, those vertebral bodies that are weakened but not yet fractured can be strengthened, thus preventing future problems.

How is Vertebroplasty Performed?

Under general anesthesia, or sometimes under sedation, a special bone needle is passed slowly through the soft tissues of the back. Image guided x-ray, along with a small amount of x-ray dye, allows the position of the needle to be seen at all times. A small amount of orthopaedic cement, called polymethylmethacrylate (PMMA), is pushed through the needle into the vertebral body.

PMMA is medical grade bone cement that has been used for many years in a variety of orthopaedic procedures.

The cement is sometimes mixed with an antibiotic to reduce the risk of infection, and a powder containing barium or tantalum, which allows it to be seen on the x-ray. When the cement is injected, it is like a thick paste, but it hardens rapidly. Usually each vertebral body is injected on both the right and left sides, just off the midline of the back.

Within a few hours, patients are up and moving around. Most go home the same day.