Treatments

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.