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  • Kyphoplasty

  • Vertebroplasty

compression fracture treatment

KYPHOPLASTY AND VERTEBROPLASTY are procedures which may dramatically reduce or eliminate the severe pain of vertebral compression fractures and allow your to get back to your usual activities almost immediately.  If you have had pain from a compression fracture that is not responding to pain

medications, physical therapy, and bracing, or if your pain is intense enough

to severely limit your usual activities of daily life, these procedures should

be considered.

HOW IS IT DONE?

First, a needle is advanced under real-time X-ray guidance (fluoroscopy)

to the fractured vertebra.  It is then inserted into bone, and a steerable

catheter is directed to the area of your fracture for repair. 

 

In KYPHOPLASTY, a balloon is then inserted through the catheter to an appropriate position. Then the balloon is slowly filled with dye under real time

X-ray visualization to create a pocket to place orthopedic cement into.  The balloon lifts and may expand the fractured compressed vertebra closer to its original height. In some cases this may restore a bit of height you may have

lost from the compressed fracture.  The balloon is then withdrawn and a type

of orthopedic bone cement  called polymethyl methacrylate or PMM

(the same as used in knee and hip replacement) is slowly and carefully 

injected, again under real time video X-ray, through the catheter into the

pocket created by the balloon.  The cement is an amazingly hard polymer

which hardens within minutes providing rapid onset of fracture repair

and pain relief.  You will be asked to lie flat after the procedure for an hour

and will then be discharged.

VERTEBROPLASTY is much like kyphoplasty except there is no balloon. 

It is used for vertebral fractures that do not need to be elevated or are

confined to a small area, or in cases in which a balloon cannot be used

for other reasons.

 

IS IT SAFE?

In the hands of an experienced pain physician this is a safe effective

procedure.  Years ago there was more concern about cement

leakage into blood vessels or around nerve structures, but with  

standardization of technique, patient selection criteria, as well as

advances in equipment, adverse effects have become quite rare.

These procedures are now considered the gold standard for treatment

of spinal compression fractures.

IS IT PAINFUL?

No, though the procedure can be performed with local anesthesia,

in general it will be performed with a type of intravenous sedation

similar to what is used in colonoscopy.  General anesthesia is not

used.  Any pain from the procedure after you are discharged should

be minimal.

compression fracture
vertebroplasty
kyphoplasty
balloon kyphoplasty
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