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Kyphoplasty

A revolutionary minimally invasive procedure known as kyphoplasty addresses the pain and deformity from compression fractures. Kyphoplasty involves two tiny incisions smaller than the diameter of a pencil on each side of the fractured vertebra.

Introduction to Kyphoplasty

Osteoporosis is defined as a skeletal disorder characterized by compromised bone strength. The National Osteoporosis Foundation cites osteoporosis as a major public health threat as 10 million people have osteoporosis and another 34 million have low bone mass. With osteoporosis, bones in our spine, hips and wrist deteriorate and might become susceptible to fractures. In the spine, small frac¬tures cause the bones to compress upon each other (called vertebral compression fractures or VCFs) causing significant back pain.

  • Are vertebral compression fractures (VCFs) difficult to diagnose?
  • Why is it important to treat VCFs?
  • What are the symptoms of a VCF?
  • Can vertebral fractures adversely affect my overall health?
  • What are the psychosocial effects of VCFs?
  • Medical Treatment of VCF
  • Kyphoplasty Relieves Back Pain for Patients with Spinal Fractures
  • What are the potential benefits of kyphoplasty?
  • Is kyphoplasty covered by insurance?
  • Are there risks associated with kyphoplasty?

Are vertebral compression fractures (VCFs) difficult to diagnose?

If a compression fracture is suspected during a physical exam, diagnosis can be confirmed with radiographic and MRI studies. If compression fractures are not diagnosed and consequently, left untreated, the physiological and psychological consequences can be devastating; therefore, it is important to have the reason for back pain investigated. Only a complete physical exam, together with an x-ray and MRI, can help your physician determine whether back pain is from a compression fracture or not.

Why is it important to treat VCFs?

After an initial vertebral fracture, the risk for having another fracture is increased fivefold. In addition, just one VCF affects the distribution of weight along the spinal column. Misalignment brought on by a fractured vertebra places more stress on adjacent vertebrae; the front of the spine has to withstand the same amount of stress with fewer functioning parts, resulting in a structure that is now weakened and vulnerable to additional fracture.

What are the symptoms of a VCF?

Most VCFs have a gradual onset, unrelated to specific injury. Fractures can occur as a result of normal activity; i.e., bending over to pick something up, reaching toward something or carrying a bag of groceries. Patients can experience pain ranging from sudden and severe, to persistent and dull. The fact that symptoms of a VCF can be easily confused with other back problems underscores the importance of obtaining a correct diagnosis and receiving treatment.

Can vertebral fractures adversely affect my overall health?

In cases of multiple fractures, kyphosis can become more pronounced, painful and debilitating. Forward curvature of the spine has a “compression effect” on your organs, making it progressively difficult to breathe, walk, eat or sleep properly. It has been shown that women older than 65 years with prevalent VCFs have an estimated 23% increase in mortality compared to patients without VCFs.

What are the psychosocial effects of VCFs?

Studies have shown that patients with multiple compression fractures experience depression, anxiety and lowered self-esteem, in addition to medical complications. The alteration in lifestyle that accompanies severe kyphosis can profoundly affect a patient’s sense of well-being and cause feelings of isolation and sadness.

Medical Treatment of VCF

The conservative management of VCF traditionally consists of bed rest, analgesics for pain, and bracing for chronic pain. While this management has its advantages, it also has its limitations:

  • The pain may not resolve even with a prolonged period of expectant management
  • Prolonged bed rest will worsen osteoporosis.
  • Conservative management does not prevent further VCF.

In those patients who are unfortunately affected by spine osteoporotic compression fractures, there are new minimally invasive techniques which can stabilize the fracture, reduce the pain, and get patients back into their daily activities.

Kyphoplasty Relieves Back Pain for Patients with Spinal Fractures

A revolutionary minimally invasive procedure known as kyphoplasty addresses the pain and deformity from compression fractures. Kyphoplasty involves two tiny incisions smaller than the diameter of a pencil on each side of the fractured vertebra. Using x-ray guidance the interventional radiologist inserts a balloon, similar to those used in cardiac angioplasty into the fractured bone. The balloon is inflated with a radiopaque dye for visualization, and inflated to restore the height of the compressed bone. The balloon is then deflated, leaving a defined cavity for the introduction of a highly viscous bone cement to stabilize the fracture. The bone cement is the same kind they use in hip and knee replacements. Kyphoplasty typically takes one hour per fracture treated and is commonly performed on an outpatient basis. The procedure can be done using either local or general anesthesia.

What are the potential benefits of kyphoplasty?

Kyphoplasty can restore vertebral body height, signifi¬cantly reduce back pain and increase mobility, often shortly after the procedure. Studies also report:

  • Significant improvement in quality of life
  • Improved ability to perform activities of daily living, such as walking, hobbies and work
  • Significant reduction in number of days where pain interfered with daily activities

Are there risks associated with kyphoplasty?

Any type of surgery involves risk. Although the complication rate for kyphoplasty is low, serious adverse events can occur, including:

  • Myocardial infarction (heart attack)
  • Cerebrovascular accident (stroke)
  • Pulmonary embolism (cement leakage that migrates to the lungs)
  • Cardiac arrest (heart stops beating)

Other risks relevant to the anatomy being treated with bone cement include deep or superficial wound infection, and leakage of cement into the muscle and tissue surrounding the spinal cord. Patients are encouraged to discuss these and other risks, with the interventional radiologist.

Is kyphoplasty covered by insurance?

In most cases, Medicare provides coverage for kyphoplasty. Other insurance plans may also cover the procedure. It is important to discuss this with our doctor and/or insurance prior to undergoing treatment.

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