Kyphoplasty is a minimally invasive procedure used to stabilize some types of vertebral compression fractures and relieve pain. It can be an effective treatment for compression fractures that cause excruciating back pain and impair patients’ ability to perform even the simplest of tasks. Such fractures often occur in people with osteoporosis, although they may also result from spinal tumors or traumatic spinal injuries.

Though most compression fractures are treated with conservative measures, such as bed rest, pain relievers, and physical therapy, there are some cases when these methods fail to provide sufficient pain relief, significantly reducing the patient’s quality of life. In such cases, kyphoplasty can be a viable option.

Kyphoplasty is a minimally invasive procedure performed under general anesthesia that repairs fractured vertebrae, stabilizes the spine, relieves pain, and, in some cases, even restores the height of the collapsed vertebra. The procedure is minimally invasive, meaning that the patient typically has small incisions and a comparatively short recovery time after the intervention. Therefore, knowing the basic principles of kyphoplasty, who are the candidates for the treatment, and what to expect before and after the procedure is essential to being able to have an open and honest conversation with the doctor about the options available for the treatment of a vertebral compression fracture.

What Is Kyphoplasty?

A kyphoplasty is a minimally invasive procedure to stabilize the vertebrae that have been fractured, reducing movement, and relieving pain. This surgical intervention is primarily used for painful vertebral compression fractures resulting from osteoporosis, and it involves collapsing a balloon within the affected vertebrae. Kyphoplasty is a safe, quick, and successful procedure for treating vertebral fractures.

During the procedure, a physician makes a small incision and inserts a thin tube into the fractured vertebra under imaging guidance. Then, a balloon is inflated to raise the collapsed vertebra. The balloon is then removed, leaving behind space that is subsequently filled with cement, which sets to form a strong structural bond inside the vertebra. Usually, kyphoplasty is performed by an interventional radiologist, orthopedic surgeon, or neurosurgeon who has received specialized training in kyphoplasty procedures.

There are limitations to the procedure, as with any medical intervention. Kyphoplasty is primarily indicated in patients with vertebral body fractures and is contraindicated in others. However, for the appropriate patient, kyphoplasty can be a valuable procedure.

Why Is Kyphoplasty Performed?

The primary objective of kyphoplasty is to relieve pain caused by vertebral compression fractures that do not improve with conservative treatment.

Prior to considering kyphoplasty, patients are typically advised to undergo conservative treatments for a period of time. This may include pain medications, limited activity, bracing, and physical therapy. When these measures fail to provide sufficient pain relief, and diagnostic tests confirm that the patient is a suitable candidate for kyphoplasty, the procedure may be recommended.

Kyphoplasty can also help restore mobility. People with vertebral compression fractures are often reluctant to move due to the pain, and even simple activities such as standing or walking can be challenging. Reduced mobility can have negative effects on general health and wellbeing. With the pain under control, patients are often able to resume many daily activities and return to physical therapy.

Another potential benefit of kyphoplasty is the correction of spinal deformity. Vertebral compression fractures can cause the vertebrae to collapse in on themselves. This can lead to kyphosis, or forward bending of the spine. While not all cases of kyphosis are severe, the condition can be physically debilitating. By partially restoring the height of the collapsed vertebrae before inserting the bone cement, kyphoplasty can help reduce spinal deformity in some patients.

Conditions That May Be Treated With Kyphoplasty

While osteoporosis is the leading cause of kyphoplasty, it is not the only condition that can lead to vertebral compression fractures.

Osteoporotic Compression Fractures

Related to a decrease in bone density due to age, particularly after menopause, vertebral osteoporotic fractures can occur when the bones become fragile and susceptible to damage. Spinal compression can happen during routine activities like bending, lifting, or even coughing.

Kyphoplasty becomes an option if conservative therapy fails to alleviate severe pain after several weeks. The decision to undergo the procedure is made by the doctor if radiological imaging reveals an appropriate fracture.

Spinal Tumors

Spine compression fractures can also be caused by metastatic malignancies that affect the bones or weaken them, making them more likely to break. Kyphoplasty can be beneficial in particular instances, allowing the patient to undergo additional therapies to treat the underlying malignancy while also stabilizing the fractured vertebra.

Multiple Myeloma

Multiple myeloma is a blood malignancy that frequently causes bone fractures. Its impact on the skeletal system can result in vertebral compression fractures in patients with multiple myeloma, making kyphoplasty a viable option for certain individuals following consultation with their physician.

Selected Traumatic Fractures

Though typically unrelated to osteoporosis, fractures caused by extreme physical force are generally not suitable for kyphoplasty. In rare instances, however, procedures involving spinal compression fractures from traumatic events can be utilized depending on the nature of the damage and the stability of the spine.

Who Is a Good Candidate for Kyphoplasty?

Not all patients with back pain or a fractured vertebra are candidates for kyphoplasty. Doctors consider several factors when deciding whether a patient is a good candidate for the procedure.

Some of the signs and symptoms that may indicate that kyphoplasty is a suitable treatment option include:

Imaging-confirmed vertebral compression fracture

Pain that persists despite treatment

Pain that limits daily activities

Recent fracture, since kyphoplasty is most effective for fractures that have occurred recently

On the other hand, kyphoplasty is contraindicated in patients with spinal infections, coagulopathy, unstable fractures, and compression fractures that do not cause pain. The evaluation includes a physical examination, history, and MRI or CT scan to confirm the diagnosis and determine if kyphoplasty is an appropriate treatment option.

How the Kyphoplasty Procedure Works

Before conducting kyphoplasty, doctors are expected to perform several diagnostic tests to determine the precise location and the time when the fracture occurred. In addition to standard imaging procedures, they might require blood tests and a review of the medications that the patient is taking, especially those that thin the blood.

The patient undergoing kyphoplasty typically lies face down on a special table during the procedure. A doctor can use either local anesthesia and sedation or general anesthesia, depending on the patient’s preferences and specific conditions.

The physician makes an incision at the desired location using a hollow needle under the guidance of a fluoroscope. Then, they can inflate a balloon to return the vertebral body to its normal shape and size partially. A doctor then removes the balloon from the incision site and fills the hollow with a special type of cement. The material inside the vertebral body quickly hardens, holding the broken bone in place while preventing additional movement. Such limitation helps reduce the pain, and the patient is able to resume their daily activities within several hours after the procedure.

The procedure for kyphoplasty usually takes about an hour or two to complete, with variations depending on the number of fractured vertebrae. Most patients can go back to their regular routines on the same day as the procedure, although others might need to spend a couple of days in the hospital, depending on their particular situation and condition.

Benefits of Kyphoplasty

For appropriately selected patients, kyphoplasty can effectively relieve the excruciating pain of vertebral compression fractures. While results vary from person to person, many patients feel better right away. In fact, some patients report significant decrease in pain within 24 hours to several days after the procedure.

Kyphoplasty is a minimally invasive procedure. It typically involves making only a tiny incision in the skin, allowing for a much faster recovery than with the traditional open surgery.

Benefits of kyphoplasty include:

It is important to remember that kyphoplasty treats the fracture, not the underlying cause. For example, it does not cure osteoporosis or other orthopedic diseases that may contribute to fractures. Patients with osteoporosis should continue to follow their treatment plans and care from their medical team, because kyphoplasty does not prevent future fractures.

Risks and Possible Complications

Although kyphoplasty is generally considered a safe procedure, there are some risks associated with it. Your doctor will discuss the potential risks and benefits of kyphoplasty with you.

Some of the possible complications of kyphoplasty include:

Cement Leak

The most common complication associated with kyphoplasty is leakage of the cement used to stabilize the vertebra. However, this rarely requires treatment. In most cases, the cement does not leak into the spinal cord or surrounding nerves. If a large amount of cement leaks, it may cause irritation or compression of the spinal cord or nerve roots. This can lead to neurological problems that may require additional treatment.

Infection

Although uncommon, infection at the site of surgery is a possible complication of kyphoplasty. Infection is rare if standard precautions are taken.

Bleeding

Bleeding from the incision site is uncommon, but it may occur. Patients taking blood thinners may need to stop taking these medications before the procedure to reduce the risk of bleeding.

Nerve Injury

Because kyphoplasty is performed near the spinal cord, there is a risk of injury to the spinal cord or other nerves. However, the risk is low, and the use of special imaging equipment during the procedure helps to avoid injury to these structures.

Allergic Reactions

Although uncommon, patients may have allergic reactions to medications used during the procedure. A thorough review of your medical history and medications by the doctor will help to minimize this risk.

Recovery After Kyphoplasty

The recovery period after kyphoplasty is significantly shorter than the healing period after traditional spinal surgery.

In most cases, patients are encouraged to resume walking immediately or after a day or two if there are no complications. Patients may also experience discomfort in the injection site for a few days, but it should be much lesser than the pain from the fracture.

Your doctor might also advise you to refrain from lifting heavy objects, exercising, and twisting your body for a certain period until the fractured vertebra heals. Most patients can return to their usual activities within a few days or weeks depending on their general health condition and the severity of the fracture.

The patient is also expected to schedule follow-up appointments to ensure that the healing process is not hindered and that the pain is subsiding. If the fracture was caused by osteoporosis, the physician may also prescribe drugs, advise on the importance of calcium and vitamin D in the diet, and recommend weight-bearing exercises to prevent future fractures.

Life After Kyphoplasty

The successful kyphoplasty enables the patient to return to being independent and do what he or she was previously unable to do due to his or her back pain.

Nevertheless, it is vital to note that for people who have osteoporosis, a chronic disease, it is important to reduce the likelihood of future fractures.

In order to do that, people at risk of osteoporosis need to consult their healthcare providers on how to make their bones stronger.

In addition, it is critical to make sure to adhere to the following lifestyle changes:

take medications recommended by a healthcare provider for osteoporosis

eat healthy and balanced meals

stay physically active

improve balance, flexibility, and posture

eliminate tobacco use and alcohol abuse

hold routine medical checkups

These measures, along with successful kyphoplasty, will ensure the best outcome for the patient.

When Should You Talk to a Healthcare Provider?

Back pain can have multiple causes, and not all require kyphoplasty. However, it is critical to consult a doctor with sudden back pain after an injury or a seemingly minor activity of daily living, especially in the elderly or people with osteoporosis.

People should seek emergency medical intervention for back pain with:

Spinal cord injury, which often leads to numbness, weakness, or loss of control over bladder or bowels. In such cases, kyphoplasty must be considered as the priority because spinal cord damage could lead to severe health problems.

Intense back pain that limits mobility. It is especially crucial for older adults as they have weaker bones that can lead to vertebral compression fractures.

A sudden decrease in height or a hunched forward posture.

Pain that persists for a few weeks, despite treatment.

The doctor will be able to decide if kyphoplasty is necessary for treating a vertebral fracture and recommend what other options are available.

Conclusion

Kyphoplasty is a minimally invasive procedure that can effectively restore mobility and relieve pain for carefully selected candidates. By mechanically stabilizing the fractured vertebral body and partially restoring it to its normal height, this procedure can significantly decrease movement-related discomfort.

Kyphoplasty is a valuable intervention, but it is not appropriate for all fractures or all patients. Patients considering kyphoplasty should understand that a thorough medical evaluation is necessary before any treatment plan is finalized.

Patients with vertebral compression fractures that do not respond to conservative care may be candidates for kyphoplasty. For more treatment options and recovery advice, explore our health and wellness articles. However, regardless of whether or not they pursue kyphoplasty, patients with compression fractures due to osteoporosis should be aware that managing their underlying condition is essential in preventing future fractures and preserving their quality of life.

Frequently Asked Questions

1. How successful is kyphoplasty?

Many patients experience significant pain relief after kyphoplasty, particularly when the procedure is performed for recent vertebral compression fractures that have not responded to conservative treatment. Individual results vary depending on the underlying condition and overall health.

2. Is kyphoplasty a major surgery?

No. Kyphoplasty is considered a minimally invasive procedure. It is performed through a small skin incision using specialized imaging guidance rather than a large surgical opening.

3. How long does recovery from kyphoplasty take?

Most patients begin walking within hours of the procedure and gradually return to normal activities over the following days or weeks. Recovery time depends on the individual’s health, the number of vertebrae treated, and the cause of the fracture.

4. Will kyphoplasty cure osteoporosis?

No. Kyphoplasty stabilizes a fractured vertebra but does not treat osteoporosis itself. Patients usually need ongoing bone-health management to reduce the risk of additional fractures.

5. Can a compression fracture heal without kyphoplasty?

Yes. Many vertebral compression fractures improve with rest, pain management, bracing, and physical therapy. Kyphoplasty is generally considered when severe pain persists despite these conservative treatments or when the fracture significantly affects daily activities.

6. Is kyphoplasty painful?

The procedure is typically performed under local anesthesia with sedation or general anesthesia, so patients should not feel significant pain during treatment. Mild soreness at the insertion site may occur afterward but usually improves within a few days.

7. How long does the bone cement last after kyphoplasty?

The bone cement used during kyphoplasty hardens permanently within the treated vertebra. It is designed to provide long-term stabilization of the fracture and does not normally need to be replaced.