Kyphoplasty and Vertebroplasty
What is Kyphoplasty?
Kyphoplasty is a minimally invasive vertebral augmentation procedure to treat acute fractures of the vertebrae. Kyphoplasty has the advantage to reduce the malalignment of the spine and restoring the height of vertebra.
What is vertebroplasty?
Vertebroplasty is an almost similar technique, only difference is that we don’t do balloon expansion of the vertebral fracture, as expansion may not be needed in these cases. Vertebroplasty has the advantages of simplicity and lower cost.
How is kyphoplasty procedure performed?
The procedure is done under the local anaesthesia. It is done by putting a needle in the fractured bone under fluoroscopic guidance and then inflating a balloon to restore bone height, then injecting special bone cement (polymethylmethacrylate) into the vertebral body. Entire procedure takes less than an hour. It is a stitch-less procedure, i.e. no suturing is required on puncture wound.
What are the indications of MISS?
Acute vertebral osteoporotic fractures (less than 3 months old).
Some traumatic vertebral fractures.
Painful Vertebral haemangiomas.
Painful pathological fractures such as multiple myeloma, spinal metastases.
Why it is required?
Treatment of osteoporotic fractures usually consist of bed rest for at least 6 weeks, pain control, calcitonin and narcotics and spinal bracing. This regimen is usually effective and most people will mostly recover. A substantial number of patients will fail to heal within 6 weeks and these require the surgery. Some patients who don’t accept bed rest do better with it.
Contraindications-
Recent systemic or spinal infection.
Uncorrected bleeding diasthesis/problems
Very poor cardiopulmonary health.
Fracture -related spinal canal compromise.
How safe is the kyphoplasty/vertebroplasty?
Procedure is very safe in expert hands. Complication rates are less than 1 %. Symptoms are improved in around 95 % of patients. This procedure is safe even in very elderly patients and usually done only in old patients.
How long it will take to recover?
Normally, patient is able to walk same day with significantly decreased pain. Patient is discharged next day after surgery, but should refrain from heavy weight lifting, prolonged travelling for at least 3 months. The doctor will recommend you medications and follow-up examination on OPD basis and radiological investigations to look for healing and to recover faster and prevent further spine-related problems.
