Vertebroplasty and Kyphoplasty: Treatments for Fractured Vertebrae
What Is Vertebroplasty?
Vertebroplasty is a technique for treating vertebral compression fractures, small breaks in the thick mass of bone that makes up the vertebral body. Vertebral body fractures lead to the collapse, or compression, of the vertebra causing the spine to shorten and curve forward. Thinning of bones is the main cause of vertebral compression fractures.
How Is Vertebroplasty Performed?
Vertebroplasty is a procedure to reinforce a collapsing vertebral body using a special cement-like material. With the patient lying on his or her stomach, the doctor inserts a hollow needle, called a trocar, through the skin and into the vertebra. A type of X-ray, called fluoroscopy, is used to guide the needle into position. A contrast agent (dye) is injected to help the doctor see and avoid blood vessels.
Once the needle is in place, a syringe is inserted to inject the cement mixture into the bone. As the cement hardens, it permanently reinforces the weakened vertebra. The procedure is usually done on both the right and left sides of the fractured vertebral body. Vertebroplasty can relieve the pain and prevent further collapse of the vertebral body. It cannot correct the spinal curve, but might help prevent further curving.
What Is Kyphoplasty?
Kyphoplasty is similar to vertebroplasty in that it uses a type of bone cement to reinforce the vertebral body. During kyphoplasty, however, an inflatable balloon-like device is inserted into the vertebra through the bone needle. As the balloon is inflated, it opens up a space that is then filled with the bone cement. In addition to stabilizing the vertebra and relieving pain, kyphoplasty restores the height of the vertebra, thereby straightening out the spinal curve.
Who Is a Candidate for These Procedures?
Vertebroplasty and kyphoplasty are generally reserved for people with chronic back pain that is not relieved by conservative treatments, such as bed rest, pain medicine and bracing. Candidates for these procedures often experience significant decreases in mobility and function as a result of the fractures. To be a candidate for vertebroplasty or kyphoplasty, a person’s pain must be related to a vertebral fracture and not due to other problems, such as disk herniation or severe arthritis. Imaging tests – such as spinal X-rays, bone scans, and computed tomography (CT) or magnetic resonance imaging (MRI) scans – might be ordered to confirm the presence of a vertebral fracture.
What Complications Can Occur?
These procedures are generally safe; but as with any procedure, there are possible complications. Potential complications of vertebroplasty and kyphoplasty include bleeding, infection, increased pain and neurological problems such as leg pain or weakness. In addition, there is a risk that cement material might leak into nearby tissues. There is also a possibility of additional fractures in people who have very thin bones as the result of severe osteoporosis.
How Effective Are Vertebroplasty and Kyphoplasty?
Vertebroplasty and kyphoplasty usually provide pain relief and improved mobility within 48 hours of the procedure. Two-thirds of patients are able to significantly reduce their use of pain medicine within a few weeks of the procedure. They are then able to gradually increase their level of activity.