Kyphoplasty and Vertebroplasty are procedures to treat vertebral compression fractures.
Vertebral compression fractures are stress fractures that occur when the normal vertebral body of the spine is squeezed or compressed to a smaller height. The bone collapses when too much pressure is placed on the vertebrae, resulting in pain, limited mobility, height loss, and spinal deformity. In very severe compression fractures, the back of the vertebral body is pushed into the spinal canal and pressure is placed on the spinal cord. They are usually caused by osteoporosis and can occur due to trauma from a fall, a forceful jump, or a car accident or a tumour of the spine.
Kyphoplasty is a spine surgery that relieves back pain caused by a vertebral compression fracture. Osteoporosis (bone disease) is the primary cause of vertebral compression fractures. Other causes include trauma such as a fall or motor vehicle accident, and some types of cancers affecting the spinal vertebrae. The aim of kyphoplasty is to relieve pain, stabilise the fracture and restore the vertebral body height.
Indications for Kyphoplasty
Your doctor recommends kyphoplasty if you have severe pain and deformity that is not relieved by non-surgical treatment modes including rest, pain medications, and braces.
Procedure for Kyphoplasty
The surgery is performed under general anaesthesia. During the procedure, you will lie face down on the operating table. A small incision is made in the back through which a narrow tube is inserted into the compressed vertebra under the guidance of live X-ray. Then a special balloon is inserted through this tube and carefully inflated. This elevates the fracture and restores the vertebra to its original height. The balloon is then deflated and removed leaving behind an open cavity. The cavity is filled with bone cement with the help of miniature surgical instruments. The cement hardens within a few minutes and stabilises the bone.
Recovery after Kyphoplasty
You may experience significant pain relief following surgery and will be allowed to get up and walk. Your doctor will prescribe pain medication if necessary and recommend a rehabilitation program to strengthen your spinal muscles. You should avoid strenuous activities for at least 6 weeks.
As with any surgery, kyphoplasty may be associated with certain complications which include infection, nerve or spinal cord injury and cement particles entering the blood or spinal fluid.
Vertebroplasty is a minimally invasive procedure which is performed to reduce or eliminate pain caused by vertebral compression fracture. It stabilises the fracture and prevents further collapse of the vertebra averting deformity. The vertebroplasty procedure involves injection of bone cement into the fractured vertebra under high pressure.
Procedure for Vertebroplasty
The procedure is done under general or local anaesthesia. You will be lying face down on the operating table. Your doctor will make a very small 1/2-inch incision in the skin over the fracture site. Under live X-ray guidance, a hollow needle called a trocar is introduced through the back and is positioned within the fractured vertebrae. Next, bone cement is injected into the area through the trocar under high pressure. After the vertebral body is filled completely with the bone cement, the needle is withdrawn before the cement hardens. X-rays or CT scans may be done to confirm the effective spread of the bone cement into the fractured vertebra. The skin incision is closed using steri-strips.
The procedure cannot be performed under the following situations:
- Compression fracture is stable and does not cause any pain
- A fractured fragment or tumour is present in the spinal canal
- Presence of a bone infection or bleeding disorder
Risks and complications
As with any surgery, some risks can occur. General complications include bleeding, infection, blood clots and reactions to anaesthesia. The specific complications following a thoracic vertebroplasty include leakage of the bone cement into surrounding soft tissues or veins and damage to the spinal cord or spinal nerves leading to numbness or paralysis.