Category: Back Surgery

Posted On: Apr 25, 2019

Written By: DR. HAMID ABBASI

Kyphoplasty and vertebroplasty are surgical procedures used to repair damaged vertebrae. Although they are similar, there are some differences. Is one better than another? How do you decide which is best for you?

The Similarities

Kyphoplasty and vertebroplasty can restore the original shape of a fractured or collapsed vertebra. When a vertebra breaks, its bone fragments can rub against each other, press on nerves that surround the spine, or poke into the spinal cord itself. By restoring the vertebra, kyphoplasty or vertebroplasty significantly lessens the patient’s back pain.

Kyphoplasty and vertebroplasty are most frequently used to repair compression fractures in the spine. Compression fractures usually occur when a vertebra collapses and tiny pieces of bone impinge or press on the nerves surrounding the spinal cord. The common culprits in this type of injury are osteoporosis and aging. But other injuries—such as car accidents or sports injuries—can also cause compression fractures.

Both kyphoplasty and vertebroplasty are minimally invasive surgical procedures, meaning that the size of the incision is much smaller than in traditional open surgery and the trauma that the surgery causes to the patient’s body is minimized. Minimally invasive surgery is considered safer because patients typically recover more quickly, have less pain, and spend less time in the hospital.

The Differences

Although both procedures have the same goal of repairing one or more fractured vertebrae, the surgical techniques used are slightly different.

Both procedures bond fragments of fractured vertebrae and rebuild and bind their shape. The major difference is that kyphoplasty uses a small balloon to create a cavity for the cement. Vertebroplasty does not. In vertebroplasty, the bone cement is injected under pressure. In kyphoplasty, the cavity is created first by expanding the balloon, and the cement can be injected with minimal pressure.

How a Kyphoplasty is Performed

Kyphoplasty is a newer procedure. In kyphoplasty, a narrow tube is inserted through a small incision. The doctor uses a fluoroscope to guide the tube to the fractured vertebra. Then a balloon is inserted through the tube and inflated. The balloon opens up a cavity inside the fractured vertebra that can receive the cement, binding the vertebra into its original shape. When the cement hardens, the fractured vertebra is stabilized.

If more than one vertebra needs to be repaired, the procedure is repeated as many times as needed. The procedure takes about an hour but can take longer if more than one vertebra needs to be repaired.

How a Vertebroplasty is Performed

In vertebroplasty, the surgeon makes a small puncture through the skin and then inserts a bone biopsy needle guided by fluoroscopic images to reach the location of the fractured vertebra. The cement is injected under pressure directly into the vertebra, fusing the broken pieces.

Pros and Cons: Kyphoplasty vs. Vertebroplasty

So which procedure is the better choice? Studies show that both procedures have roughly the same success rates. How well the patient’s pain is relieved is just about the same regardless of which procedure is performed. And there’s little long-term difference in how successful each procedure is at restoring the shape of the injured vertebra. Likewise, there’s virtually no difference in complication rates, which are very low.

In most cases, kyphoplasty and vertebroplasty are successful at significantly relieving the patient’s pain and improving mobility. Most patients are able to walk about an hour after the surgery and notice significant pain relief within a few days after surgery.

The risk of infection in kyphoplasty and vertebroplasty surgeries is low: only one in about 1,000 patients needs treatment with antibiotics after the surgery. Both procedures are very safe; however, other possible complications can include bleeding, increased back pain, and numbness and tingling.

Although considered highly effective options for repairing some spinal conditions, kyphoplasty and vertebroplasty are not good options for repairing herniated discs, spinal stenosis, or scoliosis or for relieving back pain caused by arthritis. Additionally, these procedures are not appropriate for patients who have a fractured vertebra that has already healed.

How to Prepare for Kyphoplasty or Vertebroplasty Surgery

If you’re considering kyphoplasty or vertebroplasty, your doctor will evaluate your condition by performing a physical exam. You will probably also need some blood tests and diagnostic imaging studies that include an X-ray, CT scan, or MRI of your spine.

Before the actual surgery, be sure that your doctor is aware of all of your medications, especially any blood thinners or nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen. Your doctor will tell you which medications you can take and which ones you should hold before surgery. Also be sure that you mention any other medical conditions that you have, including recent illnesses and allergies. For women, it is important for your doctor to know if there is a possibility that you could be pregnant.

Kyphoplasty and vertebroplasty are usually performed at an outpatient surgical center. However, some patients may need to stay in the hospital for a day or two. Patients who have these procedures are given either IV sedation or general anesthesia, so you will probably not be allowed to eat or drink for several hours before the surgery. If you are not admitted to a hospital after the surgery, you will need someone to drive you home.

Contact Inspired Spine

Only a skilled spine specialist can determine whether you are a candidate for kyphoplasty or vertebroplasty and which procedure is best for you. Contact the spine specialists at Inspired Spine for an expert assessment.