Vertebroplasty and kyphoplasty are procedures for the treatment of vertebral compression fractures in the spine. These treatments are minimally-invasive options for vertebral compression fractures when conventional medical therapy or treatments fail. The techniques used are different, but both procedures use an image imaging guidance system for accurate placement of an orthopedic cement mixture in the spine that is used to strengthen the vertebra and provide pain relief.
These procedures are performed to stabilize collapsed vertebrae. Vertebroplasty was initially used to treat compression fractures caused by bone cancer or bone metastasis and later to treat compression fractures caused by osteoporosis.
Vertebroplasty and kyphoplasty are usually performed on patients who:
- Are elderly
- Have trouble healing after fracture
- Have a vertebral compression fracture caused by cancer/tumor
- Have osteoporosis
The most successful vertebroplasty and kyphoplasty treatments are completed within eight weeks of the fracture. If the vertebra is not shored up before it compresses or flattens into a wedge-shape, it cannot be treated effectively.
Vertebroplasty and kyphoplasty have low complication rates and can prevent further collapse of the vertebra, helping with:
- Pain relief
- Height loss
For most people vertebroplasty and kyphoplasty are performed as outpatient procedures, with moderate sedation in a local anesthetic.
The interventional radiologist inserts a needle through a small incision in the back. An x-ray guidance system is used to accurately target the fracture vertebra where medical-grade cement is inserted.
- Vertebroplasty – the cement is injected using a hollow needle or tube that is removed after the cement is injected.
- Kyphoplasty – a balloon tamp is inserted via the needle and inflated to create a hole. The balloon is removed and cement is injected directly into the space.
The entire procedure takes about one to two hours depending on the number of bones treated. The cement hardens quickly and stabilizes the fracture, like an internal cast, and prevents further collapse. This stops the pain caused by bone rubbing against bone.
Some patients experience immediate pain relief, but most report the pain is gone or significantly better within 48 hours. Many people can resume their normal daily activities immediately.
Osteoporosis is characterized by low bone mass and structural deterioration of the bone resulting in an increased susceptibility to fractures. According to the National Osteoporosis Foundation, osteoporosis affects 10 million Americans and causes 700,000 vertebral fractures annually.
Nearly all vertebral fractures in reasonably healthy people are due to osteoporosis and can occur from a minor impact such as a bump or fall. People may not realize they have osteoporosis, because the disease is symptomless until a fracture occurs.
Multiple vertebral fractures can result in:
- Chronic pain and disability
- Loss of independent
- Stooped posture
- Compression of the lungs and stomach
Risk Factors for Osteoporosis
Factors that increase the likelihood of developing osteoporosis include:
- Abnormal absence of menstrual periods
- Advanced age
- Anorexia or bulimia
- Being female
- Being past menopause
- Being thin or having a small frame
- Diet low in calcium
- Excessive use of alcohol
- Family history of osteoporosis
- Lack of exercise
- Long-term use of corticosteroids or anticonvulsant medications