Vertebroplasty and Kyphoplasty
The vertebrae are a series of bones that make up the spine. When one fractures, it can put pressure on surrounding nerves. This can cause intense pain and disability. The bones may be repaired with these procedures.
Reasons for Procedure
Both procedures are used to decrease pain from a vertebral fracture. Kyphoplasty also restores the height of the bone. This can decrease the spinal deformity caused by the fracture.
Other treatment for vertebral fracture may include nonsurgical treatments, such as bed rest, bracing, and pain medicines.
Complications are rare, but no procedure is completely free of risk. If you are planning to have a vertebroplasty or kyphoplasty, your doctor will review a list of possible complications which may include:
Your doctor may feel that the risks of these procedures are too great if you have:
If you have vertebral fracture due to osteoporosis, vertebroplasty may not be as effective.
In addition, smoking can increase the risk of complications.
What to Expect
Prior to Procedure
Description of Procedure
You will be asked to lie down on your stomach. X-ray cameras will be positioned around you. The cameras will show images of the bone. Your doctor will use this to verify the position of the needles and cement.
The skin over the fractured bone will be numbed and sterilized. A hollow needle will be passed into the vertebra. The acrylic cement will be mixed into a toothpaste-like consistency. An added substance, called barium, will improve the images. When the needle position is ideal, the cement will be injected into the fractured bone. The doctor will watch the cement as it enters the bone to check for leaks.
Your doctor will begin by making a small incision in your back. A tiny drill will be used to create an opening in the bone. A special balloon will be passed through. The balloon will be inflated to open the space and correct the deformity. After the balloon is removed, acrylic cement will be injected into the cavity. This will help to maintain the correction.
Immediately After Procedure
You may have a CT scan to confirm the position of the cement. You will stay on your stomach for about 10-20 minutes. This will allow the cement to harden. You will then be moved to a recovery room. You will be asked to lie on your back for another hour or so.
How Long Will It Take?
40 minutes to 2 hours
How Much Will It Hurt?
You may feel some initial pain due to lying on your stomach. Many notice immediate and significant relief from pain.
Average Hospital Stay
You will usually only need to stay in the hospital for a few hours. You may need to stay longer if you have any complications.
At the Hospital
You will be monitored for a few hours for any complications.
You may notice some discomfort at the site of the needle insertion or the tiny incision. This is often relieved through the use of an ice pack (use only for 15 minutes per hour). Acetaminophen or nonsteroidal anti-inflammatory medicine may also help. You may also be given medicine to prevent muscle spasm.
You will be asked to stay in bed for about 24 hours after the procedure. After 24 hours, you can gradually increase your activities up to your usual level. Ask your doctor about when it is safe to shower, bathe, or soak in water.
Be sure to follow your doctor’s instructions.
Call Your Doctor
After you leave the hospital, contact your doctor if any of the following occurs:
In case of an emergency, call for medical help right away.
American College of Radiology
American Society of Neuroradiology
The Radiological Society of North America
Kyphoplasty. Mayo Clinic website. Available at: http://www.mayoclinic.org/vertebroplasty/kyphoplasty.html . Accessed July 1, 2007.
Predey TA, Sewall LE, Smith SJ. Percutaneous vertebroplasty: New treatment for vertebral compression fractures. American Family Physician . 2002; 66: 611-615.
Vertebroplasty. Mayo Clinic website. Available at: http://www.mayoclinic.org/vertebroplasty/vertebroplasty.html . Accessed July 1, 2007.
Vertebroplasty. RadiologyInfo website. Available at: http://www.radiologyinfo.org/en/info.cfm?pg-vertebro&bhcp=1 . Accessed July 1, 2007.
Vertebroplasty for spine fracture pain. Family Doctor website. Available at: http://familydoctor.org/748.xml . Accessed July 1, 2007.
11/9/2009 DynaMed Systematic Literature Surveillance http://www.dynamicmedical.com/what.php : Buchbinder R, Osborne RH, Ebeling PR, et al. A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med . 2009;361(6):557-568.
6/3/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/ : Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.
Last reviewed December 2011 by John C. Keel, MD