KYPHOPLASTY/ VERTEBROPLASTY

What is Kyphoplasty/ Vertebroplasty?

Kyphoplasty and Vertebroplasty are procedures designed to alleviate the pain caused by vertebral compression fractures, often stemming from osteoporosis. In vertebroplasty, a cement mixture is injected directly into the fractured bone under imaging guidance, whereas kyphoplasty involves the use of a balloon to create space within the bone before filling it with cement.

These minimally invasive techniques have shown promising results, with around 75 percent of patients experiencing improved mobility and reduced pain following treatment. Vertebral compression fractures can significantly impact a person’s quality of life, limiting their mobility and causing chronic discomfort. These fractures occur when the vertebral bodies in the spine, weakened by conditions like osteoporosis or cancer, collapse or become compressed, leading to pain and potential deformity.

By stabilizing the fractured vertebrae and restoring some of the lost height, vertebroplasty and kyphoplasty not only alleviate pain but also help patients regain functionality and activity levels. These procedures are particularly beneficial for individuals whose fractures are not responding adequately to conservative treatments like pain medications or bracing.

Diseases Treated by Kyphoplasty/ Vertebroplasty

Vertebroplasty and kyphoplasty primarily target painful vertebral compression fractures, frequently caused by osteoporosis. These procedures are often considered when conservative treatments like rest, bracing, or pain medications fail to provide relief. They are particularly beneficial for:

1. Elderly or frail individuals: These patients may have difficulty healing fractured bones, making vertebroplasty/kyphoplasty a more effective option.
2. Patients with vertebral compression from malignant tumors: The procedures can stabilize the spine and reduce pain caused by tumor-related fractures.
3. Individuals with osteoporosis due to long-term steroid use: Prolonged steroid treatment can weaken bones, leading to compression fractures that may require kyphoplasty or vertebroplasty.
4. Those with metabolic disorders affecting bone health: Conditions like hyperparathyroidism or Paget’s disease can increase fracture risk, necessitating these interventions.

For optimal outcomes, vertebroplasty or kyphoplasty should ideally occur within eight weeks of the fracture’s onset, especially for acute fractures requiring immediate attention or in patients with limited tolerance for conservative therapies.

How Does it Work?

Vertebroplasty and kyphoplasty are minimally invasive procedures used to treat vertebral compression fractures and alleviate associated pain. Here’s how each procedure works:

Vertebroplasty:

• Preparation: The patient is numbed locally, and imaging guidance helps guide the procedure.
• Injection: A hollow needle is inserted into the fractured vertebra, and a cement mixture is injected directly into the bone to stabilize it and reduce pain.
• Healing: The cement hardens quickly, typically within 20 minutes, providing immediate structural support to the vertebra.

Kyphoplasty:

• Preparation: Similar to vertebroplasty, the patient is numbed locally, and imaging guides the procedure.
• Balloon insertion: A balloon is inserted through the hollow needle into the fractured vertebra and inflated to create a cavity or space within the bone.
• Cement injection: The balloon is then removed, and the cavity created is filled with a cement mixture, providing structural support and pain relief.
• Monitoring: X-rays or CT scans may be used to ensure proper cement distribution.

The procedures are typically performed by interventional radiologists or neuroradiologists in specialized suites. Patients may receive sedatives but usually do not require general anesthesia. The entire process, including preparation and injection, usually takes about an hour per treated vertebral level. Afterward, patients are monitored for a short period and may be discharged the same day unless further observation is necessary.

Post Recovery Care

After kyphoplasty or vertebroplasty, post-recovery care is important for optimal healing and pain management. For the first 24 hours, take it easy and rest when fatigued. Keep the incision covered and dry for a day, then gently pat it dry after showering. Avoid strenuous activities, including bending and heavy lifting, for several weeks. Refrain from driving for two weeks and wear your back brace while walking but not during sleep. Resume regular medications as directed. Stick to your normal diet, but opt for bland, low-fat foods if your stomach is upset. Gradually increase activity levels and follow any physical therapy or pain management recommendations diligently. Adhering to these guidelines promotes a smoother recovery and reduces the risk of complications, ensuring a faster return to daily activities.

FAQs

1. What is the difference between kyphoplasty and vertebroplasty?

Kyphoplasty and vertebroplasty are both minimally invasive procedures used to treat spinal compression fractures. In vertebroplasty, a special cement is injected directly into the fractured vertebra to stabilize it. Kyphoplasty, on the other hand, involves first inserting a balloon into the vertebra and inflating it to create space. The balloon is then removed, and the space is filled with bone cement. Kyphoplasty not only stabilizes the fracture but can also restore some of the vertebra’s original height, potentially reducing spinal deformity and improving posture.

2. Who is an ideal candidate for kyphoplasty or vertebroplasty?

Ideal candidates for kyphoplasty or vertebroplasty are individuals suffering from painful vertebral compression fractures, often due to osteoporosis, cancer, or trauma. Candidates typically experience significant back pain that limits their mobility and does not respond to conservative treatments such as pain medication, physical therapy, or bracing. The procedures are most effective when performed within a few weeks to months after the fracture occurs. A thorough evaluation, including imaging studies like X-rays or MRI, is necessary to determine if these procedures are appropriate for the patient’s specific condition.

3. What can I expect during the recovery period after kyphoplasty or vertebroplasty?

Recovery from kyphoplasty or vertebroplasty is usually swift, with many patients experiencing immediate pain relief. Most patients can go home the same day or after an overnight stay. It is common to feel some soreness at the injection site, which typically resolves within a few days. Patients are generally advised to avoid heavy lifting and strenuous activities for several weeks to allow the treated vertebrae to fully stabilize. Follow-up appointments are necessary to monitor healing and ensure there are no complications. Gradually, patients can resume their normal activities as tolerated.

4. Are there any risks or complications associated with kyphoplasty and vertebroplasty?

Both kyphoplasty and vertebroplasty are generally safe, but as with any medical procedure, there are potential risks. These include infection, bleeding, and allergic reactions to the materials used. Rarely, complications such as cement leakage, which can potentially compress nearby nerves or the spinal cord, may occur. There is also a small risk of new fractures developing in adjacent vertebrae. Thorough preoperative assessment and precise technique during the procedure minimize these risks. Discussing all potential risks and benefits with your doctor is crucial before undergoing treatment.

5. How does kyphoplasty/vertebroplasty impact long-term spinal health?

Kyphoplasty and vertebroplasty can significantly improve long-term spinal health by stabilizing fractures, alleviating pain, and enhancing mobility. These procedures help prevent the progression of spinal deformities, such as kyphosis (forward curvature of the spine), which can occur due to untreated compression fractures. By restoring vertebral height and alignment, kyphoplasty, in particular, may contribute to better posture and reduce the risk of future fractures. Patients are often encouraged to engage in bone-strengthening activities and take medications to manage osteoporosis and maintain overall spinal health.

6. Can kyphoplasty or vertebroplasty be repeated if needed?

Yes, kyphoplasty or vertebroplasty can be repeated if additional vertebral compression fractures occur in the future. Each new fracture is evaluated on a case-by-case basis to determine the most appropriate treatment. The ability to perform repeat procedures offers flexibility in managing ongoing spinal health issues, particularly in patients with conditions like osteoporosis, which predispose them to multiple fractures. Maintaining regular follow-up care and monitoring bone density can help manage underlying conditions and reduce the likelihood of future fractures, potentially minimizing the need for repeat interventions.

 

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