FAQs on Kyphoplasty and Vertebroplasty in Atlanta


Vertebral compression fractures (VCFs) affect many aging people and are a cause of severe debilitating pain. VCFs account for half of all osteoporotic fractures.

For patients with concurrent spinal instability or a neurologic deficit, kyphoplasty or vertebroplasty are indicated. These minimally invasive procedures restore vertebra height and reduce the risk of future fracture.

What happens with a vertebral compression fracture?

If a patient has a VCF, the body of the bony vertebra collapses into itself, which produces a wedged vertebra. If several of the vertebrae collapse, kyphosis (hump back) develops. Patients with osteoporosis have weak bones and are at risk for VCF. Any activity can cause this to occur, such as sneezing, coughing, or lifting. A patient with a VCF experiences severe back pain, problems with sleep, and loss of mobility.

What happens before the procedure?

Kyphoplasty and vertebroplasty are both surgical procedures, so before the surgery, you are required to have some tests, such as bloodwork and x-rays. Be sure to advise the Atlanta pain management doctor of any and all medications you are taking, as certain blood thinning agents must be held for several days before the procedure. You are not allowed to eat or drink after midnight before the procedure.

How is vertebroplasty performed?

Once you arrive at the medical facility, the nurse will explain the procedure, have you sign a consent form, and start an IV catheter in your arm. You will be changed into a gown. The doctor will give you a sedative or put you under general anesthesia before cleansing the back with an antiseptic solution.

A small needle is used to inject a local anesthetic into the skin and deeper tissues. Once numb, small incisions are made over the fracture, and a hollow needle is inserted under x-ray guidance into the vertebrae that is fractured. Through this needle, cement is injected into the fractured portion of the bony structure. The needle is then removed, the incisions are closed with stitches or steri-strips, and a bandage is applied.

How is kyphoplasty performed?

Just like vertebroplasty, you will arrive at the surgical center and be prepared for the procedure. Once the skin is cleansed and numbed, the Atlanta pain management doctor will make some small incisions over the fractured vertebra and insert a hollow needle into the vertebra. An attached balloon is inflated into the compressed area of the vertebra to expand it.

Cement is then inserted to restore the normal height of the bony structure. After the needle device is removed, the incisions are closed with steri-strips or stiches, and a bandage is applied.

Who is a candidate for these procedures?

Research proves that persons who sustain one osteoporotic fracture are 5 times more at risk for additional fractures. Because of this fact, anyone with a VCF who has underlying bone problems should have kyphoplasty or vertebroplasty to treat the injury. Both procedures are safe and effective for people with metastatic tumors, multiple myeloma, or a benign tumor.

Can kyphoplasty or vertebroplasty help old and chronic fractures?

These procedures are not recommended for old and chronic VCFs. They cannot reduce kyphosis in older fractures. Most Atlanta pain doctors recommend kyphoplasty or vertebroplasty when the VCF first occurs, which prevents further bone collapse.

Are kyphoplasty and vertebroplasty effective?

In a large clinical study, the success rate regarding pain relief was 87% for vertebroplasty and 92% for kyphoplasty. In one review of the two procedures that involved almost 6,000 VCFs, both procedures were found to offer significant pain reduction, which lasted for up to 2 years with kyphoplasty and up to 5 years with vertebroplasty.

Resources

Fourney DR, Schomer DF, Nader R, et al. (2003). Percutaneous vertebroplasty and kyphoplasty for painful vertebral body fractures in cancer patients. J Neurosurg, 98:21–30.

Kasperk C, Hillmeier J, Noldge G, et al. Treatment of painful vertebral fractures by kyphoplasty in patients with primary osteoporosis: a prospective nonrandomized controlled study. J Bone Miner Research, 20:604–12. doi: 10.1359/JBMR.041203.

Ploeg WT, Veldhuizen AG, The B, et al. (2006). Percutaneous vertebroplasty as a treatment for osteoporotic vertebral compression fractures: a systematic review. Eur Spine Journal, 15:1749–1758.

Taylor RS, Taylor RJ, Fritzell P (2006). Balloon kyphoplasty and vertebroplasty for vertebral compression fractures: a comparative systematic review of efficacy and safety. Spine, 31:2747–55. doi: 10.1097/01.brs.0000244639.71656.7d.