What Is Kyphoplasty And Vertebroplasty?

Kyphoplasty and vertebroplasty are two minimally invasive treatment methods that may be performed for patients suffering from vertebral compression fractures. This particular kind of fracture develops as a result of a spinal vertebra that has deteriorated or collapsed, and it often occurs in individuals who have osteoporosis, a condition that causes brittle bones. Bone cancer or a traumatic injury may also cause vertebral compression fractures. Once a compression fracture develops, an individual may begin to suffer from persistent pain, decreased mobility, and the spine may begin to curve excessively.

When alternative treatments that involve the administration of anesthesia, a back brace, or bed rest are recommended for vertebral compression fractures, the fracture may not heal properly. If a patient’s condition does not improve, then kyphoplasty or vertebroplasty may be suggested.

How Is Kyphplasty And Vertebroplasty Performed?

Before the kyphoplasty procedure begins, the patient is positioned on their stomach and then imaging equipment such as a fluoroscope or an X-ray is used to insert a needle into the region where the targeted vertebra is located. After correct placement has been confirmed, an inflatable balloon is carefully fed through the needle and then cement is injected into the balloon. The procedure may be performed with two balloons through a bipedicular technique or with one balloon through a unipedicular technique.

Vertebroplasty is a similar approach that also involves having a patient lie on their stomach, but it differs in that cement is injected directly into the damaged vertebrae in order to help restore the original length of the spine as well as straighten any abnormal spinal curvature. The use of cement poses the risk of leakage, but this does not typically occur. Although this technique is effective, the unipedicular kyphoplasty approach is more frequently performed because it allows complications from cement leakage to be avoided. Kyphoplasty also requires less exposure to radiation from the X-ray or fluoroscope because the operating time is shorter.

There are a number of additional risks that are associated with these two techniques. Vertebroplasty, for example, may cause temporary bleeding and anemia to occur. Blood clots have also been shown to increase as a result of this technique. For some patients who undergo kyphoplasty, the risk of experiencing cardiac complications increases. This type of complication, however, is most often observed in patients who are older and were previously diagnosed with different health issues. Therefore, patients with known medical conditions are usually recommended for vertebroplasty. Nonetheless, the occurrence of cardiac problems after kyphoplasty is minimal so this treatment approach is still the more common of the two, especially since it is associated with fewer complications and most patients can leave the hospital sooner. In actuality, patients treated with kyphoplasty are typically released after one night. In some cases, a patient may even be discharged shortly after the procedure.

Conditions Related To Vertebroplasty And Kyphoplasty

Kyphoplasty and vertebroplasty are treatments that are commonly utilized to treat pain that is associated with a vertebral compression fracture. Several conditions that have been shown to increase the occurrence of this type of fracture include:

  • Bone cancer metastasis
  • An injury that resulted from blunt trauma
  • Osteoporosis

Patients who undergo kyphoplasty as a form of verterbral compression fracture treatment typically report rapid reductions in pain relief, briefer recovery periods, and longer spinal lengths. In addition, many patients experience dramatic improvements in their mobility and overall well-being. A clinician generally evaluates each individual patient’s case and considers the desired length of the spinal column in order to determine if one or two balloons should be inserted.

Patients who did not experience positive results from conventional treatments typically feel significantly better after undergoing vertebroplasty. In addition, this approach has proven to be more effective at stimulating healing as well as the repair of damaged vertebrae than kyphoplasty.

Brittle bones often develop as a result of a condition known as osteoporosis and when this occurs, the bones can no longer support the weight of the body properly. As this disease progresses, the incidence of compression fractures also increases. If a patient has developed a compression fracture, complaints such as severe back pain and a reduced quality of life may be reported. Spinal abnormalities may also be observed and compression fractures have also been associated with higher mortality rates. Furthermore, bone cancer that metastasizes can lead to lesions on spinal bones, making them much more susceptible to fractures.

Blunt trauma may also cause spinal vertebrae to become injured and this may lead to a fracture. Regardless of the condition that causes the fracture, kyphoplasty and vertebroplasty are utilized the same way to treat the injury. Furthermore, both of these procedures afford most patients with improved mobility as well as significant relief from chronic pain that begins approximately two days after the treatment. In some cases, patients have experienced relief earlier than two days after the procedure and were able to quickly return to their everyday lives.

Conclusion

Kyphoplasty and vertebroplasty are treatment methods that are often recommended for vertebral compression fractures. Spinal injuries that developed due to a trauma, bone cancer that has metastasized, or osteoporosis are health problems that are typically associated with the development of these types of fractures. Both of these approaches are quick and some patients may be discharged as soon as a couple of hours after the procedure. Pain relief may be experienced within the first two days, if not sooner.

References

  1. Goz V, Errico TJ, Weinreb JH, Koehler SM, Hecht AC, Lafage V, Qureshi SA. Vertebroplasty and kyphoplasty: national outcomes and trends in utilization from 2005 through 2010. Spine J. 2013; in press.
  2. Hu Z, Zhao G, Wang L, Pu B, Hao J, Lao H, Zhang X, Gan Q, Jiang W. Related Biological Research in the Interface between Bone Cement and Bone after Percutaneous Vertebroplasty. Int J Endocrinol. 2013; 2013:109784.
  3. Klazen CA, Lohle PN, de Vries J, Jansen FH, Tielbeek AV, Blonk MC, Venmans A, van Rooij WJ, Schoemaker MC, Juttmann JR, Lo TH, Verhaar HJ, van der Graaf Y, van Everdingen KJ, Muller AF, Elgersma OE, Halkema DR, Fransen H, Janssens X, Buskens E, Mali WP.Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open-label randomised trial. Lancet. 2010; 376(9746): 1085-1092.
  4. Ledlie JT, Renfro M. Balloon kyphoplasty: one-year outcomes in vertebral body height restoration, chronic pain, and activity levels. J Neurosurg. 2003; 98: 36-42.
  5. Li LH, Sun TS, Liu Z, Zhang JZ, Zhang Y, Cai YH, Wang H. Comparison of unipedicular and bipedicular percutaneous kyphoplasty for treating osteoporotic vertebral compression fractures: a meta-analysis. Chin Med J (Engl). 2013; 126(20): 3956-3961.
  6. Papanastassiou ID, Phillips FM, Van Meirhaeghe J, Berenson JR, Andersson GB, Chung G, Small BJ, Aghayev K, Vrionis FD. Comparing effects of kyphoplasty, vertebroplasty, and non-surgical management in a systematic review of randomized and non-randomized controlled studies. Eur Spine J. 2012; 21(9): 1826-1843.
  7. Pflugmacher R, Beth P, Schroeder RJ, Schaser KD, Melcher I. Balloon kyphoplasty for the treatment of pathological fractures in the thoracic and lumbar spine caused by metastasis: one-year follow-up. Acta Radiol. 2007; 48(1): 89-95.