Vertebroplasty and Kyphoplasty
Vertebroplasty is a nonsurgical, minimally invasive procedure during which we stabilize one or more injured bones in the spine (vertebrae) by injecting medical-grade cement into the injured areas. We usually recommend vertebroplasty for patients who are too frail to undergo spinal surgery, whose vertebrae are too weak, or whose vertebral damage is due to a spinal tumor. Seventy-five to 90 percent of patients who undergo vertebroplasty will have complete or significant pain reduction, studies show.
Kyphoplasty is a type of vertebroplasty used to repair painful compression fractures in the spine, when all or part of a vertebra collapses. A common cause of these compression fractures is thinning of bones, or osteoporosis. During the procedure we guide a small balloon to the site of compression and inflate it inside the vertebra, creating a void. We then deliver bone cement directly into the newly created void to restore the original height and angle of the fractured vertebrae.
How do I get ready for the procedure?
Your doctor will discuss with you which medications you may take on the days before, and on the day of, your surgery. Do not drink or eat anything for several hours before the procedure.
What will happen during the procedure?
After you arrive at our interventional radiology suite, we will give you antibiotics and a sedative intravenously. We will have you lie face down on a table, and will then numb the skin and muscles near the spinal fracture(s) with a local anesthetic. After making a small incision we will insert a hollow needle, and will guide it to the injured bone using fluoroscopy (continuous X-ray imaging) to show us the position of the needle inside the vertebra. Once we have correctly positioned the tip of the needle we will inject medical-grade, orthopedic (bone) cement into the affected vertebra. The cement hardens within 10 to 20 minutes. During kyphoplasty we guide a special balloon through a tube into the vertebrae, then carefully inflate it. As the balloon inflates the fracture expands and returns to a more normal position. We then remove the balloon and fill the cavity with cement. The entire procedure typically takes one to two hours for each collapsed vertebra.
Are there any risks?
There is a very small chance of complications from vertebroplasty; these complications include infection, fever, bleeding, increased back pain, nerve irritation, another fracture of the spine or ribs, and very rarely, paralysis. Patients with spinal tumors may be at higher risk for developing complications of vertebroplasty. In addition, in some cases a very small amount of cement may leak out of the vertebra.
After the procedure
After the procedure is finished we will ask you to lie flat on your stomach for one to two hours until the cement has completely hardened. Most patients are then able to stand and walk with little or no pain, and can return home. At home you should rest in bed for the first 24 hours after the procedure. You may feel sore at the incision point for the next few days and can use ice or over-the-counter pain relievers with approval to ease the discomfort. Your back pain should resolve or feel significantly better within 48 hours of the procedure.