A vertebral fracture or a break in one of the spinal vertebrae is a condition that can make it difficult for individuals to move freely. When a vertebral break occurs the bone fragments may rub against each other, resulting in debilitating pain. In this article, we will discuss a minimally-invasive procedure known as kyphoplasty. The goals of this procedure are to stabilize the fractured or broken vertebrae, restore any lost vertebral height, and hopefully provide patients with pain relief.
Who is a Candidate?
Individuals who have weakened bones due to cancer or people with a collapsed or compressed vertebrae due to osteoporosis, may be candidates for kyphoplasty. Older patients who recently had some type of accident or fall that resulted in a fractured or broken spinal vertebrae may be a candidate for this type of procedure as well. The procedure is typically reserved for older patients since the long-term effects of one of the components (bone cement) has not yet been thoroughly been tested on the younger population.
How is the Procedure Performed?
Kyphoplasty is a minimally-invasive procedure that involves inserting a specially-designed catheter tube tipped with a balloon, into a small incision near the affected spinal vertebrae. Once guided into place, the balloon is then inflated creating a small space where bone cement will be injected. After the space is created the balloon is deflated and removed, then bone cement is injected into the remaining cavity. The bone cement takes about 10 minutes to harden.
For patients with severe, debilitating pain caused by a compression fracture or break, the hope is that the procedure will:
- Correct any spinal deformity.
- Restore lost vertebral height.
- Increase patient mobility.
- Reduce/eliminate the use of pain medication.
Preparing for Kyphoplasty
In order to have the best possible outcome, the physician performing the procedure will likely recommend that their patient quit or at least reduce unhealthy behaviors such as tobacco or alcohol use. This will allow the best possible environment for maximum post-op bone healing. About a week before the procedure is to be performed, patients will be advised to halt the use of blood thinner and/or NSAID medications in order to minimize the risk of excessive bleeding or interactions with anesthesia during the procedure. If a patient takes other medications, they should discuss them with their physician to best determine how to maintain their regular dosage without compromising the procedure. No food or drink will be allowed 6 hours prior to a patient’s scheduled surgery time, although the patient may be allowed a small amount of water up to 2 hours prior.
A general outline of the procedure is as follows:
- An anesthesiologist provides medication to either relax the patient or put them completely to sleep.
- Using an X-ray machine for guidance, the physician will insert a thin tube through the skin and back muscles to reach the affected area.
- The balloon attached to the thin catheter tube will be inflated, thus creating a cavity for the bone cement, and then deflated.
- Using the X-ray machine again, the physician will make sure the bone cement is inserted into the correct area.
No stitches are needed and unless additional vertebrae require treatment, the entire procedure usually takes less than an hour. The patient will be allowed to recover for 1-2 hours in the recovery room. In most cases, if no complications are noted the patient is released to recover at home. For some of their patients, physicians may recommend an overnight stay in the hospital. Whether a patient is allowed to go home on the same day or if they have to stay overnight, they should arrange for transportation to drive them home. Many patients are able to walk within an hour of the procedure and begin to feel pain relief within a few days.