WHAT ARE VERTEBROPLASTY AND KYPHOPLASTY?

Vertebroplasty and Kyphoplasty are minimally invasive procedures for the treatment of Vertebral Compression Fractures (VCF). These fractures occur in the bones (vertebrae) that make up the spinal column and are often caused by the loss of bone density, strength and mass due to a medical condition called osteoporosis. Vertebrae may also become weakened by cancer or medications.

REASON FOR THE PROCEDURES

Vertebroplasty and Kyphoplasty are used to treat painful VCFs in the spine by re-enforcing the broken vertebrae with liquid cement. Typically, these procedures are recommended after less invasive treatments, such as bed rest, use of a back brace or pain medication, have been ineffective, or once medications begin to cause undesired side effects, such as stomach ulcers or changes in mental status. Vertebroplasty and Kyphoplasty are also performed on patients who are too frail to tolerate an open spinal surgery or whose bones are too weak for surgical repair. These procedures are also performed on patients that suffer from osteoporosis as a result of long-term steroid treatment or a metabolic disorder.

THE PROCEDURE

The two procedures are very similar in that image guidance is used to inject a cement mixture into the fractured bone through a hollow needle. In Vertebroplasty, the cement is injected with high pressure between the fractured bone pieces. With Kyphohplasty, a balloon is first inserted into the fractured bone through the hollow needle to create a cavity or space. Once the balloon is removed, cement is slowly injected into the cavity. Vertebroplasty binds the broken fragments together, whereas Kypohplasty flattens the fractured bone pieces allowing for a solid cement base to be formed. Kyphoplasty creates a more stable foundation and can, therefore, help patients regain height that was lost due to the compression.

SIDE EFFECTS, RISKS, AND COMPLICATIONS

There is some question whether both procedures may increase the likelihood of secondary VCFs in nearby vertebrae because of extra pressure applied due to the rigidity of the cement. However, it is difficult to determine if the secondary VCF would have occurred despite the procedures. Risks may include infection, leakage of the cement into other surrounding muscles and tissue leading to paralysis and leakage of cement into blood vessels that could damage the heart and lungs.