Cyphoplasty is an surgical operation for the treatment of fractures of the vertebral compression. It can reduce pain and make mobility much greater. This offers an alternative which is minimally invasive to other surgeries.
This article discusses what is involved in the procedure, why somebody may need it, plus benefits, hazards, complications and recovery.
What is it?
Kyphoplasty is a surgery with vertebral augmentation to treat vertebral fractures. Such fractures may occur due to conditions like osteoporosis or trauma.
A related technique is vertebroplasty. Both of these treatments involve inserting plastic bone cement through a hole in the skin into the fracture.
The distinction between the two methods is that kyphoplasty often seeks to regain height by fixing the curvature of the spine. This involves inflating a tiny balloon in the vertebra to create space before injecting cement into the bone. This operation is called balloon kyphoplasty by some physicians.
According to an article in the Journal of Spine Surgery, in 2014, surgeons performed some 19,420 kyphoplasty procedures across the US.
The average cost of a 2006–2014 kyphoplasty procedure was $15,295.
Why is it needed?
A surgeon may undergo cyphoplasty for a vertebral compression fracture (VCF). VCF occurs when the bony block in the spine collapses, which can cause extreme height loss, deformity, and pain.
The incidence of VCF increases with age, and most result from low-energy injuries in older osteoporosis patients. Other possible causes of VCF’s, however, include trauma from car accidents or sports injuries or tumors that have begun in the spine or spread to the bones.
According to OrthoInfo from the American Academy of Orthopedic Surgeons (AAOS), many people who have a VCF recover to repair the fracture within 3 months without any specific treatment. A doctor will sometimes recommend that a person wear a brace to restrict movement, which helps heal the fracture.
If an individual has severe pain that does not respond to non-operative treatment, then surgery is an option. A doctor will talk to the individual about the procedure that suits them most. That will depend on their type of vertebral compression.
Procedure
A doctor may recommend that a person avoid taking drugs that make it difficult for the blood to clot, such as aspirin and warfarin, during the days prior to surgery. On the day of surgery, it will likely tell a person not to eat or drink anything for several hours before the procedure. A person can take any medication approved by a doctor, as well as sips of water.
In a hospital or outpatient clinic a surgeon will perform kyphoplasty. A person may have either local anesthetics or general anesthetic. The operating procedure is as follows:
- A surgeon will insert a needle into the spine bone through the skin. They will then use X-ray images to guide them to the correct area.
- They will then place a small device called a balloon tamp through the needle and into the fractured vertebra.
- The surgeon will inflate the balloon tamp. This helps to restore the height of the vertebrae.
- When the surgeon removes the balloon tamp, it leaves a cavity that is injected with acrylic bone cement to prevent it from collapsing again.
Many patients can go home from hospital the same day. A person should not be driving, unless approved by a medical professional.
Recovery time
The AAOS suggest that most people can return to their normal daily living activities without any restrictions following surgery. A person should check with their doctor or surgeon whether there are any activities they should avoid during the period of recovery.
There may be some discomfort in a person’s back where the surgeon inserted the needle, but this usually will not last longer than a few days.
Risks and complications
The risks and complications of kyphoplasty may include:
- infection
- increased back pain
- bleeding
- nerve damage
- allergic reaction to the chemicals used with X-rays to help guide the surgeon
- acrylic bone cement leaking out of position
A 2016 review shows that although risks are uncommon, there may be serious complications, including compression of the spinal cord, compression of the nerve root, venous embolism and pulmonary embolism, including cardiovascular collapse.
Kyphoplasty complication rates are at less than 2 percent for osteoporotic VCFs, and up to 10 percent for malignant tumor-related VCFs, according to the American Association of Neurological Surgeons.
Benefits
Osteoporotic vertebral fractures correlate with elevated morbidity. Techniques such as kyphoplasty can provide relief from pain and improve functionality of the spinal support.
People who have a kyphoplasty operation afterwards may have a better quality of life. We may need fewer pain relievers, and be more mobile.
However, kyphoplasty’s efficacy seems to be under debate within the medical community. A individual will speak with their doctor about the benefits and risks.
Summary
Kyphoplasty can improve the quality of life and mobility of a person, and reduce pain and the use of medication for pain relief. If the non-surgical means do not work, a doctor may recommend kyphoplasty.
There is debate about the effectiveness of kyphoplasty, and there is a risk of complications.
Anyone considering having this procedure should consult with their doctor about the benefits and risks.
