Treatments
6. Kyphoplasty Surgery (minimally invasive)
Objective: To stop pain caused by spinal fracture, stabilize the bone, and restore body height lost to compression fracture. Indicated for: Patients experiencing painful symptoms or spinal deformities from recent osteoporotic compression fractures. For restoring height, the procedure should be completed within 8 weeks of when the fracture occurs for best chance of success. Not Indicated for: Established deformity of the spine. Moreover, not every patient with osteoporosis will benefit from this procedure.
Treatment: During kyphoplasty surgery, we make a small skin puncture incision in the back and insert a narrow tube, using x-rays (fluoroscopy) to guide it to the fractured area. Next, we insert a special balloon through the tube and into the vertebrae, then gently inflate it. As the balloon inflates, it elevates the fracture, returning the pieces to a more normal position. It also compacts the soft inner bone to create a cavity inside the vertebrae. We then remove the balloon and use specially designed instruments to fill the cavity with a cement-like material called polymethylmethacrylate (PMMA), which hardens quickly, stabilizing the bone.
Kyphoplasty surgery is performed at a hospital under local or general anesthesia, and takes about one hour for each vertebra involved.
Post-Treatment: You should expect to spend one day in the hospital recovery room, being observed closely, after the procedure. Driver needed? Yes. Moreover, patients should not drive until given approval.
Time to Relief: Immediate for some patients. In others, elimination or reduction of pain is reported within two days. Rate of Complications: Some general surgical risks apply to kyphoplasty, including a reaction to anesthesia and infection. Other risks that are specific to the kyphoplasty procedure and vertebroplasty include 1. Nerve damage or a spinal cord injury from malpositioned instruments placed in the back. 2. Nerve injury or spinal cord compression from leaking of the PMMA into veins or epidural space. 3. Allergic reaction to the solution used to see the balloon on the x-ray image as it inflates.
Please keep in mind that osteoporosis is a chronic, progressive disease. If you’ve sustained fractures from osteoporosis are at an increased risk for additional fractures due to the loss of bone strength. It is not known whether kyphoplasty or vertebroplasty will increase the number of fractures at adjacent levels of the spine. Bench studies on treated bone have shown that inserting PMMA does not change the stiffness of the bone, but human studies have not been done.
Discharge Instructions: At home, you can return to your normal daily activities. However, you should avoid strenuous exertion, such as heavy lifting, for at least six weeks. During recovery, you should see us to begin or review your treatment plan for osteoporosis, including medications to prevent further bone loss.