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Kyphoplasty

Kyphoplasty/Vertebroplasty is used mainly to treat painful compression fractures in the spine.

In a compression fracture, all or part of a spine bone collapses. Kyphoplasty involves inflating a balloon at the site of the fracture and then immediately filling the cavity created by this balloon with quick-setting bone cement. The cement provides immediate stability to the spine, restoring its former shape and preventing the treated vertebra from collapsing again. The procedure is also called balloon kyphoplasty.
Minimally invasive techniques such as kyphoplasty use a combination of intra-operative fluoroscopy to provide pictures and advanced instruments to conduct the procedure. These small tools allow the surgeons to make smaller incisions resulting in shorter operating time, faster recovery and less pain.

Hospital Stay: Hospital Stay: 3 days
Duration: Duration: 2 hrs
Cost Estimate: Cost Estimate: 4500 USD - 14000 USD These are indicative prices in Indian Hospitals

This procedure is indicated in patients with severe and disabling pain for 2 months or more that does not get better with bed rest, pain medicines, and physical therapy.

Kyphoplasty treats compression fractures, which most commonly occur in the spine as a result of osteoporosis or secondary to a tumor. A compression fracture can result when the progressive weakening of bone causes a vertebra to collapse on itself. This collapse shortens the spine, creating a “humpback,” and often causes chronic pain when the fallen vertebra pinches a spinal nerve.

Your doctor may also recommend this procedure if you have a painful compression fractures of the spine due to

  • Cancer, including multiple myeloma
  • Injury that caused broken bones in the spine

Risks

Kyphoplasty is generally safe. Complications may include:

  • Bleeding
  • Infection
  • Allergic reactions to medicines
  • Breathing or heart problems if you have general anesthesia
  • Leakage of the bone cement into surrounding area causing pain if it affects the spine or nerves. Leakage can lead to other treatments to remove the cement.

Before the Procedure

Before surgery, always tell your doctor or nurse:

  • If you could be pregnant
  • What drugs you are taking, even those you buy without a prescription
  • If using any blood thinners
  • If you have been drinking a lot of alcohol

During the days before the surgery:

  • You may be asked to stop taking aspirin, ibuprofen, coumadin (warfarin), and other drugs that make it hard for your blood to clot.
  • Ask your doctor which drugs you should still take on the day of the surgery.
  • If you smoke, try to stop

On the day of the surgery:

  • You will usually be told not to drink or eat anything for several hours before the test.
  • Take your drugs your doctor told you to take with a small sip of water.

Surgery:

Kyphoplasty is done in a hospital or outpatient clinic.

  • You may have local anaesthesia (awake and unable to feel pain). You will likely also receive medicine to help you relax and feel sleepy.
  • You may receive general anaesthesia. You will be asleep and unable to feel pain.

You lie face down on a table. The health care provider cleans the area of your back and applies medicine to numb the area.
The doctor places a needle through the skin and into the spine bone. Real-time x-ray images are used to guide the doctor to the correct area in your lower back.
A balloon is placed through the needle, into the bone, and then inflated. This restores the height of the vertebrae. Cement is then injected into the space to make sure it does not collapse again.

After the Procedure

  • You should be able to walk. However, it is best to stay in bed for the first 24 hours, except to use the bathroom.
  • After 24 hours, slowly return to your regular activities.
  • Avoid heavy lifting and strenuous activities for at least 6 weeks.
  • Apply ice to the wound area if you have pain where the needle was inserted.

Outlook (Prognosis)

Kyphoplasty has two primary aims, to relieve the back pain associated with compression fractures, and to straighten and stabilize the spine. By surgically correcting the problem, kyphoplasty can eliminate the need for more traditional treatments of compression fractures: bracing, bed rest, and medication to reduce or relieve pain.

The results of kyphoplasty, the restoration of upright posture, height, and spinal stability and mobility, and more importantly, a dramatic reduction in back pain–are both immediate and long-lasting.

Kyphoplasty/vertebroplasty are techniques used for treating vertebral compression fractures, small breaks in the thick mass of bone that makes up the front part of the vertebra. Vertebral body fractures lead to the collapse or compression of a vertebra, causing the spine to shorten and curve forward. This can result in pain and a kyphotic (hunched-over) deformity. Thinning of bones, or osteoporosis, is the main cause of vertebral compression fractures. Pathologic fractures related to spinal tumors may also be a cause of fractures. During the procedures, the patient will lie on his or her stomach. The doctor will then insert a hollow needle, called a trocar, through the skin and into the vertebra. A type of X-ray, called fluoroscopy, is used to guide the trocar into proper position. Once the trocar is in place, either cement (vertebroplasty) or an inflatable balloon-like device (kyphoplasty) are inserted into the vertebra through the trocar. During a kyphoplasty, as the balloon is inflated, it opens up a space to be filled with bone cement. In addition to stabilizing the vertebra and relieving pain, kyphoplasty/vertebroplasty attempt to restore the height of the vertebra, thereby straightening out the spinal curve.

Kyphoplasty/vertebroplasty is generally reserved for people with painful progressive back pain secondary to osteoporotic or pathologic vertebral compression fractures. Candidates for these procedures often experience significant decreases in mobility and function as a result of the fractures. To be a candidate for a kyphoplasty/vertebroplasty, a patient’s pain must correlate to the vertebral fracture, and must not be due to other problems, such as disk herniation, arthritis, or stenosis. Imaging tests – such as spinal X-rays, bone scans, and CT or MRI scans – might be ordered to confirm the presence of a vertebral fracture.

Kyphoplasty/vertebroplasty are considered minimally invasive procedures that are most often performed using general anesthesia, depending on the doctor and the needs of the patient. In most cases, this procedure is performed as an overnight stay, although many patients do go home the same afternoon.

Patients may feel sore in the area where the trocar was inserted. However, this should resolve within a couple of days. Applying ice to the area can help relieve any soreness.

Kyphoplasty/vertebroplasty usually provide pain relief and improved mobility within 48 hours of the procedures. In some cases, however, patients feel pain relief immediately. The majority of patients are satisfied with the results, with many returning to all their usual activities they were performing before the vertebral fracture occurred.

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