Kyphoplasty / Vertebroplasty

Kyphoplasty/vertebroplasty is a minimally invasive procedure employed for the management of vertebral compression fractures (VCF). VCF is generally caused by spinal tumors, traumatic injury and osteoporosis. VCF results in pain and impaired mobility of the spine.

The conventional treatment of vertebral compression fractures included complete rest, braces, and pain medications. However, kyphoplasty/vertebroplasty provides faster recovery and decreases the risk of recurrent fractures. The procedure involves the injection of bone cement into the fractured or compressed vertebrae which re-establishes the normal height of the damaged vertebrae.

In vertebral compression fractures (VCF) the body of the vertebrae collapses and the spine may become wedge-shaped, known as kyphosis. VCF can result from osteoporosis, multiple myeloma and physical activities such as excessive strain, lifting heavy weight and sneezing or coughing.

The patient with VCF present with back pain, reduced lung capacity, depression and difficulty in movement and sleep.

Procedure

The basic steps involved in Kyphoplasty/vertebroplasty include:

• The patient is placed on the operation table and sedated
• The affected segment of the spine is sterilized
• X-ray images are used to identify the placement of the incision
• A small incision is made and two large needles are inserted, at different angles, into the vertebral body through the pedicle; under fluoroscopic guidance
• An inflatable balloon is inserted, through one of the needles, into the compressed vertebrae and inflated to restore the normal height of the vertebrae
• Once the normal height of the vertebrae has been achieved, the balloon is deflated and withdrawn
• This procedure is called kyphoplasty, as it reduces abnormal curvature of the spine i.e. kyphosis, before stabilizing it
• The bone cement is filled into the prepared space
• The pressure and the quantity of the cement to be injected is monitored to prevent any leakage
• The needles are removed and the incision is closed and sutured

Post operative care

After the procedure most patients are observed for a day and discharged the next day. The basic post-operative instructions for the patients who undergo kyphoplasty/vertebroplasty include:

• Post-operative pain is managed by medications such as painkiller and narcotics
• Avoid any strain or stressful movement for the first 24 hours, then gradually resume your routine activities
• Maintain proper posture while sitting, standing, sleeping and lifting; in consultation with your physiotherapist
• Start physical therapy as and when recommended by your neurosurgeon
• Keep the incision clean and dry

Risks and complications

As there are few complications associated with every surgery. The complications associated with kyphoplasty/vertebroplasty include:

• The leakage of the bone cement that may cause compression or blockage of neural foramen and result in nerve pain
• Bleeding
• Damage of the spinal nerves that may cause numbness or paralysis
• Infection