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Kyphoplasty, which is very similar to Vertebroplasty, is a minimally-invasive procedure that is designed to help people suffering from severe back pain most likely caused by cracked, fractured, compressed or collapsed vertebrae. Kyphoplasty is a surgical procedure that is used when other treatments fail to relieve pain. (DeNegri 2007.)
Anatomy
The backbone consists of individual bony structures called vertebrae that interlock together to give strength and structure to the spine. These vertebrae allow us to move and also protect the spinal cord. The vertebrae may develop fractures, compress or collapse. Bone fragments may then irritate the nerves of the spine or the spinal cord.
Conditions commonly treated with Kyphoplasty and Vertebroplasty include:
- Osteoporosis
- Trauma or Injury
- Bone cancer metastasis
Procedure
The patient lies on his or her stomach. After the back is sterilized, a local numbing cream is applied. The patient may also take sedatives in order to relax. An X-Ray or other such guiding machine is used to ensure correct placement of small needles that are carefully placed into the vertebral body.
In balloon-assisted Vertebroplasty, a strong inflatable balloon is inserted through a tube in into the vertebral body.
The small balloon is slowly inflated. The balloon fills the center of the vertebrae. Using low pressure, the balloon later is filled using special bone cement.
Benefits
Kyphosis is a condition that is known to give the patient a pronounced curve or hump on his or her upper back. The most common cause is from compressed fractures of the vertebrae. Severe Kyphosis may cause debilitating pain and is a serious medical condition.
The benefits of having Kyphoplasty is that one’s height may be restored, pain is relieved and vertical alignment is improved. In a 2006 study, after having this procedure, 80% of patients recovered their height. 90.7% of patients had fracture improvement. (Shindle 2006). If height recovery is a goal, then the Kyphoplasty procedure may have some added benefits from Vertebroplasty.
Risks
Kyphoplasty is considered a generally safe procedure. There are some risks, but it is considered appropriate to alleviate the pain of vertebral compressed fractures. The potential risks include the slight chance that there may be cement leakage out of the vertebral body. Serious complications are rare; but may include: infection, bleeding, numbness, tingling, headache, and paralysis from improper placement of the needle or cement. The risk of improper needle placement is decreased by using an imaging device, during the procedure.
Studies have shown that Kyphoplasty is a very safe treatment for debilitating and painful fractures of the vertebra, with only rarely having complications. (DaFonseca 2006)(Hiwatashi 2007).
Outcome
Kyphoplasty and Vertebroplasty are procedures that have significant benefits to those suffering the severe pain of Kyphosis. Patients experience immediate relief, improved movement and mobility, and 95% of patients reporting partial or complete pain relief (Hiwatashi 2007).
Fracture Prevention
Good general health is the best prevention; and includes a balanced diet, regular exercise, weight lifting, calcium and vitamin D supplements. Bisphosphonates medications (Aredia and Fosamax) for Osteoporosis treatment may prevent future compression fractures. These types of medications improve bone strength and bone density. Individuals with compression fractures may be good candidates for proven minimally invasive, including Kyphoplasty (Old 2004).
There is a guideline available to people who experience chronic spinal pain that was written by the American Society of Interventional Pain Physicians. It is a practice guideline for management with surgical techniques. The evidence suggests that vertebral augmentation procedures such as Kyphoplasty and Vertebroplasty give relief (Boswell 2007).
For more information about Kyphoplasty or Vertebroplasty, or other items mentioned, please see your pain physician.
Resources/Journal Articles:
- Kyphoplasty – PainDoctor.com
- Shindle MK, Gardner MJ, Koob J, Bukata S, Cabin JA, Lane JM. Vertebral height restoration in osteoporotic compression fractures: kyphoplasty balloon tamp is superior to postural correction alone.
- Osteoporosis Int. 2006 Dec; 17(12):1815- 9. Retrieved from Epub 2006 Sep 16 PMID: 16983458
- DaFonseca K, Baier M, Grafe I, Libicher M, Noeldge G, Kasperk C, Meeder PJ. Orthopade. 2006 Oct; 35(10):1101-9 PMID: 17195295. [Balloon kyphoplasty in the therapy of vertebral fractures]
- Boswell MV, Trescot AM, Datta S, Schultz DM, Hansen HC, Abdi S, Sehgal N, Shah RV, Singh V, Benyamin RM, Patel VB, Buenaventura RM, Colson JD, Cordner HJ, Epter RS, Jasper JF, Dunbar EE, Atluri SL, Bowman RC, Deer TR, Swicegood JR, Staats PS, Smith HS, Burton AW, Kloth DS, Giordano J, Manchikanti L; American Society of Interventional Pain Physicians. Pain Physician. 2007 Jan;10(1):7-111 PMID: 17256025. Interventional techniques: evidence-based practice guidelines in the management of chronic spinal pain.
- Hiwatashi A, Westesson PL. AJNR Am J Neuroradiol. 2007 Apr;28(4):690-2 PMID: 17416822 .Vertebroplasty for osteoporotic fractures with spinal canal compromise.
- De Negri P, Tirri T, Paternoster G, Modano P. Clin J Pain. 2007 Jun;23(5):425-30 PMID: 175. Treatment of painful osteoporotic or traumatic vertebral compression fractures by percutaneous vertebral augmentation procedures: a nonrandomized comparison between vertebroplasty and kyphoplasty.