Kyphoplasty

What is Kyphoplasty?

Kyphoplasty is a procedure used to treat certain fractures in vertebrae, or bones of the spine.

The  fractures treated by kyphoplasty are compression fractures. These fractures usually occur in bones weakened by osteoporosis (a thinning of the bones) or a tumor. In compression fractures, the solid section of bone known as the vertebral body collapses. These fractures are not only painful, but they may put harmful pressure on the nearby nerve roots or on the spinal cord itself.

A kyphoplasty treats these fractures by making space in the bone that was lost when the bone collapsed, then filling that space with a solid, cement-like mixture.

When is this Procedure Performed?

For the most part, nonoperative treatments like pain medication, activity modification, and/or bracing are recommended for fractures. Vertebral fractures typically take about three months to fully heal with these measures.

However, surgery may be recommended when:

  • the nonoperative measures do not provide relief
  • the spine appears to be unstable
  • the fracture has put pressure on the spinal cord

Kyphoplasty may not be right for all fractures. An experienced neurosurgeon, like those at the Spine Hospital at the Neurological Institute of New York, will evaluate an individual case and determine the best procedure for that patient.

How is this Procedure Performed?

In adults, this procedure may be performed under local anesthesia. This means a patient is conscious, yet unable to feel pain. A sedative may be administered to help the patient relax and feel sleepy during the procedure. Or, the procedure may be performed under general anesthesia, which means the patient is asleep and unable to feel pain. This is the option of choice for pediatric patients.

To perform the kyphoplasty, the doctor uses a thin surgical instrument, like a needle with a balloon inside it. The instrument is inserted through the skin and back muscles and into the bone. The surgeon then inflates the balloon, which comes out the end of the needle and creates a space in the vertebra as it inflates. This portion of the procedure usually helps the bone regain its normal shape.

Next, the surgeon injects the filler mixture through the needle and into the balloon. X-ray images help the surgeon guide the instruments and ensure that the filler goes into the right place. This cement-like mixture sets and prevents the bone from collapsing again.

The doctor then removes the needle. Since the incision is so small, this procedure does not require stitches.

The entire procedure usually takes less than an hour. If more than one vertebra requires treatment, the procedure may take longer.

Complications that may result from a kyphoplasty are not common, but may include:

  • Infection
  • Bleeding
  • Increased back pain
  • Tingling, numbness, or weakness because of nerve damage
  • Allergic reactions to chemicals used during X-rays to help the doctor put the balloon in the right place
  • Filler leaking out of position

The amount of radiation released from the x-ray during the procedure is considered low; therefore, the risk for radiation exposure is minimal. If you are pregnant or may be pregnant, notify your doctor before the procedure.  There may be other risks that depend on the presence of certain medical conditions. Be sure to discuss any concerns with the surgeon before the procedure.

How Should I Prepare for this Procedure?

Before the procedure, your doctor will meet with you to check your health, perform a physical examination, and order blood work. At this time, your doctor will order tests such as X-rays or an MRI scan to get updated images of the fracture.

Make sure to tell your doctor about any medications that you’re taking, including over the counter medication and supplements, especially medications that can thin your blood such as aspirin. Your doctor may recommend you stop taking these medications before your procedure. To make it easier, write all of your medications down before the day of surgery.

Be sure to tell your doctor if you have an allergy to any medications, food, latex (some surgical gloves are made of latex) or to contrast agents (dyes used during some X-rays).

On the day of surgery, remove any nail polish or acrylic nails, do not wear makeup and remove all jewelry. If staying overnight, bring items that may be needed, such as a toothbrush, toothpaste, and dentures.

What Should I Expect After the Procedure?

You may feel some soreness where the needle was put into your back, and this may last a few days. You may notice less back pain compared to before the procedure.

How long will I stay in the hospital?
Patients are usually discharged on the day of surgery or the next morning.

Will I need to take any special medications?
You may be prescribed vitamins, minerals, and medications to help strengthen the bones and prevent more fractures in the spine.

Will I need to wear a brace?
Your doctor will determine whether or not a brace is needed after your kyphoplasty procedure.

When can I resume exercise?
Patients are usually encouraged to walk as soon as possible, often an hour after the procedure. Ask your surgeon about any activities that you should avoid following the procedure. Strenuous exercise should be avoided for 4-6 weeks following the procedure.

Will I need rehabilitation or physical therapy?
Physical therapy is not necessary following kyphoplasty.

Will I have any long-term limitations due to kyphoplasty?
There are no long-term limitations due to kyphoplasty.

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