What is Kyphoplasty and Vertebroplasty?

Kyphoplasty and vertebroplasty explained by Denver, Golden, Aurora, Boulder, Broomfield, Jefferson, and Littleton Colorado’s top pain doctors

VertebroplastyKyphoplasty and vertebroplasty are treatments for vertebral compression fractures that involve minimally invasive techniques. Compression fractures refer to the collapse or deterioration of spinal vertebrae. Individuals who have bone cancer that has metastasized, osteoporosis that developed because of brittle bones, or experienced a traumatic spinal injury tend to suffer from these types of fractures. Decreased mobility, chronic pain, and excessive curving of the spine are the typical signs of a vertebral compression fracture.

A physician will generally recommend kyphoplasty or vertebroplasty if a patient has tried conventional treatments such as local injections with anesthesia or steroids, back braces, or bed rest to treat a compression fracture, but pain relief is not being experienced or the fracture is taking too long to heal.

How are Kyphoplasty and Vertebroplasty Performed?

Kyphoplasty entails having a patient lie on the stomach and then inserting a needle through the skin into the targeted vertebrae. In order to ensure that the needle is placed at the correct location, a fluoroscope or X-ray is used to guide the insertion of the needle.

After the correct placement has been confirmed, an inflatable balloon is inserted through the needle. Kyphoplasty may be performed through a bipedicular approach, in which two balloons are inserted, or through a unipedicular approach, in which one balloon is inserted.

Vertebroplasty involves the same procedure as kyphoplasty, but cement is injected through the needle into the space between the spinal vertebrae instead of a balloon. The use of cement or an inflated balloon leads to the restoration of the spinal cord length and reverses excessive curving. Cement leakage is one of the main risks associated with vertebroplasty, but the actual occurrence is low.

The unipedicular kyphoplasty technique that involves one balloon is the most commonly used method because it eliminates the risks associated with injecting cement into the body, it has a shorter operating time, and it exposes patients to much lower amounts of radiation.

However, both techniques pose some additional risks. For instance, a higher incidence of anemia due to bleeding temporarily after the procedure and an increased risk of developing blood clots is associated with vertebroplasty. It has also been reported that undergoing kyphoplasty increases the occurrence of cardiac problems, especially in older patients who are suffering from additional medical conditions. As a result, physicians recommend that patients with several underlying conditions undergo vertebroplasty instead of kyphoplasty. However, the risk of experiencing cardiac distress is low and, therefore, kyphoplasty is still the most commonly performed approach between the two techniques due to the lower rate of complications and the shorter hospital stay. More specifically, most patients who undergo kyphoplasty can usually leave the hospital one day after having the procedure and some are even released on the same day after being monitored for a certain time period.

Conditions Related To Kyphoplasty And Vertebroplasty

Compression-FractureKyphoplasty and vertebroplasty are typically performed in order to treat pain that is the result of a vertebral compression fracture. The following conditions are associated with these types of fractures:

  • Bone cancer metastasis
  • Spinal injuries sustained from a trauma
  • Osteoporosis

Osteoporosis develops when bones become brittle and hinder the spine’s ability to properly bear the weight of the body. This increases the risk of developing a vertebral compression fracture. Once a fracture occurs, an individual will begin to experience intense back pain, a decreased quality of life, and spinal deformities as well as an increased mortality rate. When bone cancer metastasizes, lesions begin to develop on spinal vertebrae and this also leads to an increased incidence of vertebral compression fractures.

In addition, blunt trauma can cause serious injury to the spinal cord and vertebrae, which can results in fractures. Vertebral compression fractures may develop from other conditions or events, but a physician’s decision to recommend kyphoplasty or vertebroplasty depends on factors that include the severity of the fracture, whether or not a patient has an existing medical condition, and the potential risk of each procedure.

OsteoporosisIt has been reported that the degree of pain relief is higher for vertebroplasty than kyphoplasty, especially when traditional treatments are ineffective. Furthermore, vertebroplasty supports the healing and repair of compression fractures for much longer periods than the kyphoplasty approach.

When the kyphoplasty technique is utilized as a treatment for vertebral compression fractures, chronic pain rapidly decreases, vertebral length can be restored, and patients have reported accelerated recovery rates. Increased mobility and quality of life are also reported by most patients who undergo this procedure. Each patient’s particular case as well as the desired restoration length of the spine is considered when determining whether to insert one or two balloons.

Overall, both procedures provide patients with significant pain relief and improved mobility approximately 48 hours following the treatment. Patients have also reported feeling pain relief in a much shorter time period as well as the ability to return to their normal daily routines. 

Conclusion

Procedure PreperationKyphoplasty and vertebroplasty are common treatment methods for vertebral compression fractures. Bone cancer that has metastasized, spinal injuries due to trauma, and osteoporosis are conditions that are generally associated with the development of these types of fractures. The formation of blood clots and temporary bleeding are risks that are associated with vertebroplasty, while cardiac problems may develop from kyphoplasty, but the occurrence is low. Both approaches are brief and patients may even be discharged one day after the procedure or on the same day. Furthermore, patients generally experience pain relief during the first two days if not sooner.

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References

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