Kyphoplasty
A spinal compression fracture occurs when a bone in the spine weakens, often as a result of osteoporosis, causing all or part of the spine bone to collapse. These fractures can lead to severe pain and reduced mobility as well as to a more severe form of compression where the entire vertebral body (the front section of the vertebra) collapses.
Our UF Health pain medicine specialists are experts in a number of minimally invasive procedures including kyphoplasty which can be used as a treatment for painful spinal compression fractures. This procedure typically results in significantly reduced pain and improved mobility, leading to a better overall quality of life. Patients often experience a decreased need for pain medication and enjoy greater ease of movement after spine surgery.
What is kyphoplasty?
Kyphoplasty is also known as balloon kyphoplasty or cementoplasty. It is a minimally invasive procedure used to treat painful spinal compression fractures in the spine. Kyphoplasty is often an outpatient procedure.
The kyphoplasty procedure is done in a hospital or outpatient clinic, usually under local anesthesia. This means an anesthetic will be applied to a specific area of your body, numbing it so that you will not feel pain. You will be awake during the procedure, though you may also be given medication to make you relaxed and sleepy. Occasionally patients are put under general anesthesia which means you will be asleep and unable to feel pain during the procedure.
Kyphoplasty is a percutaneous procedure which indicates it can be performed with a needle passing through the skin so that no incision is needed for this minimally invasive procedure.
A balloon is placed through the needle, into the bone, and then inflated. This restores the height of the vertebrae. Medical-grade bone cement is injected into the balloon and quickly hardens. This orthopedic cement stabilizes the fracture, strengthening the bones, and providing pain relief.
The kyphoplasty procedure usually lasts around an hour, though it may take longer for patients with multiple fractures that need to be addressed.
This procedure is similar to vertebroplasty, but a balloon is not used in that procedure.
Your provider may recommend this procedure if you have severe and disabling pain for two months or more that does not get better with conservative measures such as bed rest, pain medicine, and physical therapy. They may also recommend this procedure if you have a painful spinal fracture due to cancer, including multiple myeloma, or if you’ve had an injury that caused broken bones in the spine.
How are spinal compression fractures diagnosed?
A spinal compression fracture, also known as a vertebral compression fracture, can occur suddenly and cause severe back pain. The pain is most commonly felt in the middle or lower spine but can also be felt on the sides or in front of the spine. The pain, which is sharp and “knife-like,” can be disabling and can take weeks or months to go away on its own.
Spinal compression fractures can be diagnosed using X-rays, CT scans, or MRI scans. These scans are used to diagnose both the severity and exact location of the fracture, which will help your physician determine whether kyphoplasty may be a viable course of treatment.
What are kyphoplasty risks?
Kyphoplasty is generally safe. Complications may include:
- Bleeding.
- Infection.
- Allergic reactions to medicines.
- Breathing or heart problems if you have general anesthesia.
- Nerve injuries.
- Leakage of the bone cement into surrounding area (this can cause pain if it affects the spinal cord or nerves). Leakage can lead to other treatments (such as surgery) to remove the cement. In general, kyphoplasty has less risk for leakage of cement than vertebroplasty as the cement is placed within the balloon.
What to know before the procedure
Following pre-procedure instructions is an important way that you can help your physician lower the risk of complications and maximize the chance of successfully reducing or eliminating your symptoms.
Always tell your provider:
- If you could be pregnant.
- What medicines you are taking, including those you bought without a prescription.
- If you have been drinking a lot of alcohol.
During the days before the surgery:
- You may be asked to stop taking aspirin, ibuprofen, coumadin (Warfarin), and any other medicines that make it hard for your blood to clot several days before.
- Ask which medicines you should still take on the day of the surgery.
- If you smoke, try to stop.
On the day of the surgery:
- You will most often be told not to drink or eat anything for several hours before surgery.
- Take the medicines your provider told you to take with a small sip of water.
What to know after the procedure
Following all postoperative instructions from your healthcare provider is an important way to speed your recovery time and lower the risk of complications.
- If you have soreness at the spot where the needle was inserted, apply ice to the area.
- While some patients experience immediate pain relief, others have an increase in pain for a short period of time due to inflammation at the injection site. Your doctor may prescribe over-the-counter medications to address this temporary pain.
- You should be able to walk. However, it's best to stay in bed for the first 24 hours, except to use the bathroom.
- After 24 hours, slowly return to your regular activities.
- Avoid heavy lifting and strenuous activities for at least 6 weeks.
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