Kyphoplasty
What is Kyphoplasty?
Kyphoplasty is a minimally invasive treatment for spine fractures that provides
rapid relief from back pain, helps to straighten the spine, and allows you to
return quickly to usual daily activities.
What is a spine fracture?
The normal spine has 24 vertebrae that stack upon each other, forming a gentle
"S" shaped curve. The part that fractures is the vertebral body, the
thick block of bone that forms the front part of the spine. The vertebral bodies
provide structural support for your spine.
Vertebral fractures and resulting changes:
A vertebral body fracture occurs when the vertebral body cracks (or fractures)
and collapses. This causes your spine to shorten and to fall forward (kyphosis)
above the fracture, resulting in a hunched over appearance. The change in the
shape of your spine can cause difficulty with walking and everyday activities
such as lifting, reaching, pushing, and pulling.
What causes spine fractures?
Most vertebral fractures result from osteoporosis, a disease that weakens your
bones. When bones are weakened by osteoporosis, even minor falls or routine
activities can result in fractures.
What are some of the symptoms of a spine fracture?
Your doctor will need to diagnose your condition, but you might be alert to
some of the indications of spine fracture. Pain may or may not be associated
with spine fractures. You might be aware that you are about two inches shorter
than you used to be, or you might have quite a bit of pain in the area of the
spine that is fractured. The pain may be severe enough that you seek medical
treatment.
After a few vertebral fractures, the shape of your spine will change to a stooped
or hunched profile. You may have persistent pain due to the tendons and ligaments
in your back being stretched by your curved spine. If the pain is only relieved
by lying down and not moving, you might suspect a vertebral fracture.
If you suspect that you have a spine fracture, it is important to see your
doctor as quickly as possible. The likelihood of straightening your spine is
much better with early treatment, and most people do not want to live with pain
longer than they have to. Only your doctor can determine if Vertebroplasty is right
for you.
Other than pain or a shortened, curved profile, are there other effects of
vertebral fractures?
You might experience sleeping problems, breathing disorders, and loss of appetite.
Some people develop depression or anxiety due to concern that they will experience
another fracture. Of most concern is the risk for serious, even fatal, lung
problems.
ABOUT THE SURGERY
What will Vertebroplasty do for me?
It is designed to provide fast relief of back pain, helps straighten the spine
and allows quick return to daily activities.
What about risks and complications?
Vertebroplasty is a minimally invasive procedure; however, there are potential
risks with any surgical procedure, and your doctor will discuss these with you.
Complications are rare, but you need to be aware that they can happen.
How is the procedure done?
First, you will have a medical examination and diagnostic tests to determine
the location of fractures and the condition of your bone.
You will have anesthesia, either general or local, as you and your doctor decide
is appropriate for you.
The procedure takes about an hour for each vertebra treated.
The procedure has 4 steps:
The four steps are usually done on the right and left sides of the fractured
vertebral body.
STEP 1:
Your doctor will make a narrow, half-inch incision in your back and make a
very small pathway into the fractured vertebral body.
STEP 2:
A small bone balloon is placed through the pathway into the vertebral fracture.
STEP 3:
Your doctor will restore the height of your vertebral body by carefully inflating
the balloon. This is an important step in helping to straighten your spine.
STEP 4:
An "internal cast" is created inside the vertebral body as the space
is filled with a cement-like material of your physician's choice that will support the bone and prevent further collapse.
AFTER THE PROCEDURE
What should I expect regarding recovery time?
Your doctor may want you to stay in the hospital one day. Daily activities
vary quite a bit from person to person, and you will discuss with your doctor
when to resume specific activities. You will want to be sure that you have an
appointment for a follow-up office visit in about six weeks.
How do I know if I am at risk for vertebral fractures?
If you have been diagnosed with osteoporosis you are at risk for fractures.
The following have been associated with an increased likelihood of osteoporosis:
- Older age
- Female
- Family history of osteoporosis
- History of fractures as an adult
- Early menopause (naturally or as a result of surgery)
- Race: Caucasian and Asian are at high risk, followed by African American
and Hispanic
- Small boned and slender women (less than 127 pounds)
- Diet/Lifestyle: low calcium intake, little weight bearing exercise, using
tobacco, using alcohol to excess
- Certain medications used on a regular basis can damage bone, such as those
used to treat rheumatoid arthritis, gastrointestinal diseases, seizures, and under-active
thyroid. Glucocorticoids are a class of medications that are particularly
damaging to bones. Your doctor can advise you if any of the medications you take on a
routine basis increase your risk for osteoporosis.
Can I prevent vertebral fractures?
For most people, osteoporosis is preventable. Developing strong bones before
age 30 is an excellent start, then maintaining them through a healthy diet with
plenty of calcium and vitamin D, a healthy lifestyle with weight-bearing exercise,
and no smoking or excessive alcohol.)
Bone density testing can indicate if medication is necessary to boost bone
development.
Current medications approved by the FDA for osteoporosis prevention and treatment
include estrogen, alendronate, raloxifene and risdronate. Calcitonin is used
for treatment only. Other promising medications are currently being investigated.
Women are at greater risk for osteoporosis. However, men are susceptible to
osteoporosis as well.
