Kyphoplasty, similar to Vertebroplasty, is a treatment and minimally invasive out-patient procedure that is used for pain relief from spinal column compression fractures. Kyphoplasty is a proven treatment used when other conservative treatments and therapies have failed to provide adequate or significant pain relief.

Anatomy

The bony structures of the spinal column consist of individual vertebrae (spinal bones) that interlock together. The vertebrae provide strength for the whole body; they allow for movement and also protect the spinal cord.

Vertebral compression fractures are when the vertebrae develop small cracks, break or collapse. This may cause bone fragments to damage or irritate the spinal nerves or the spinal cord, causing pain in the process.

Conditions commonly treated with Kyphoplasty and Vertebroplasty include:

• Osteoporosis
• Trauma or Injury
• Bone cancer metastasis

Procedure

The patient lies on their stomach. The skin on the back is sterilized and a local-numbing agent is administered. Sedatives are administered to aid in relaxation. An imaging device, such as X-ray, is used to guide needle placement. Small needles are 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

Kyphoplasty has been shown to enhance height in individual vertebrae and restore vertical alignment of the spinal column. Many patients with compression fractures have kyphosis.

Kyphosis (hump back) is a pronounced curve or hump in the upper back. There are a few causes of Kyphosis, but a common cause is vertebral compression fractures. Severe kyphosis is a serious medical condition. It may be debilitating and perhaps a source of embarrassment when there is an obvious hump in the upper back.

In a 2006 study, Kyphoplasty was shown to enhance height and accounted for over 80% of recovered height. Kyphoplasty was shown to have a 90.7% for fracture improvement, after the procedure. If height recovery is a goal, then the Kyphoplasty procedure may have some added benefits from Vertebroplasty.

Risks

Kyphoplasty is generally considered a safe and appropriate procedure for most patients with vertebral compression fractures. However, as with any procedure there are potential risks.

One risk is the possibility of bone cement leakage outside 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.

Aside from any potential risks, published studies indicate Kyphoplasty as a safe treatment method for painful vertebral compression fractures; and complications are rare with this procedure.

Outcomes

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.

Kyphoplasty and Vertebroplasty are innovative methods that have the potential to provide significant benefits. They offer back-pain relief and improved mobility in patients with vertebral fractures. In a 2007 article, a reported 95% of people treated with these procedures showed partial or complete immediate pain relief.

The American Society of Interventional Pain Physicians developed a large evidence-based practice guideline for chronic spinal pain management with interventional techniques. The article concluded that vertebral augmentation procedures, the evidence of relief and improvement is moderate for both Vertebroplasty and Kyphoplasty.

For more information about Kyphoplasty or Vertebroplasty, or other items mentioned, please see your pain physician.

Resources

• 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.