Vertebroplasty & Kyphoplasty: Pain Relief for Vertebral Compression Fractures
Vertebroplasty & kyphoplasty are two treatment options that are performed to treat compression fractures in the spine. These fractures are typically caused by severe osteoporosis as the vertebral body in the spine weakens and collapses. The consequences of a compression fracture are severe pain, loss of height, deformation, breathing difficulty and eventual nerve compression.
Vertebroplasty & kyphoplasty are very similar procedures. Both are minimally invasive and are designed to relieve the intense pain associated with a compressed and fractured vertebra.
A vertebroplasty not only relieves pain, but it also strengthens a vertebra that is weakened but not yet fractured. It is usually performed as an outpatient procedure. Patients are typically under sedation, but the procedure can be done under general anesthesia. Patients are usually able to walk and move around within a few hours.
During a vertebroplasty, a hollow bone needle is inserted through the patient's skin and soft tissue and into the fractured vertebra. The surgeon is aided by image-guided x-ray and x-ray dye, so the needle is visible at all times during the operation.
A special bone cement called polymethylmethacrylate is injected through the bone needle and into the fractured vertebra. Often, this cement is combined tantalum or barium powder to allow it to be visible on the x-ray. An antibiotic is sometimes mixed in to lessen the risk of infection. The cement hardens within 10 minutes once injected. All fragments of the broken vertebra are then stabilized.
A more recently developed technique than vertebroplasty, kyphoplasty has the added benefit of restoring the height lost by vertebral compression. Up to 90 percent of the pain due to compression fractures can be alleviated through this minimally invasive procedure.
The operation is usually performed with the patient under general anesthesia, but it can also be done under local anesthesia. Aided by image-guided x-rays, the surgeon cuts two small incisions and uses a probe in the place where the fracture is located. The bone is then drilled and balloons called bone tamps are inserted on each side of the vertebra. Next, the surgeon inflates the balloons. This helps to restore the vertebra to the size it was before the collapse. It also corrects any abnormal vertebral wedging. After the balloons have been inflated to their maximum size, the surgeon removes them and fills the cavity they created with polymethylmethacrylate, the same type of bone cement used in vertebroplasty.
Recovery time after kyphoplasty is very quick. A patient whose procedure was performed under local anesthesia is able to return home within a few hours. Normal daily activities can be resumed within 48 hours.
While both vertebroplasty & kyphoplasty are excellent treatments for osteoporosis patients, most clinicians will generally allow about three months for a compression fracture to heal on its own. Patients not in extreme debilitating pain are usually advised to wait this long before deciding to opt for surgical intervention.