What is Vertebroplasty & Kyphoplasty?

Vertebroplasty and kyphoplasty are two minimally invasive procedures that stabilize painful vertebral compression fractures (VCF), the most common type of fracture of the vertebral bodies of the spinal column.

Vertebral compression fractures occur when a vertebral body fractures. This causes compression of the classic rectangular shape of the bone and is typically accompanied by pain. These compression fractures can affect any number of the vertebrae in the spine and are a frequent consequence of osteoporosis. Osteoporosis is a disease that leads to a gradual loss of the normal density, mass and strength of bone, creating a condition where bones become more porous and prone to breaking easily. Cancer can also weaken the vertebrae.

In vertebroplasty, a cement mixture is injected into the fractured bone using image guidance, frequently fluoroscopy, through a hollow needle. In kyphoplasty, a balloon is introduced into the fractured bone through the hollow needle to create a cavity or space. Cement is then injected into the cavity after the removal of the balloon.

What are some common uses of the procedures?

Vertebroplasty and kyphoplasty are indicated for painful vertebral compression fractures in the spine, mainly as a result of osteoporosis.

The treatments are typically suggested when less invasive treatments such as bed rest, a back brace, or pain medication proves ineffective at alleviating symptoms. However, for patients whose pain is problematic enough for them to be hospitalized or whose conditions prevent adequate bed rest or adequate pain medications, vertebroplasty and kyphoplasty can be performed urgently.

Vertebroplasty and kyphoplasty can be conducted in the following individuals:

Are geriatric or have fragile bodies and are likely to have poor healing of the bone after fracture.
Have vertebral compression as a consequence of a malignant tumor.
Have osteoporosis as a result of long-term administration of steroids or have a metabolic disease.
Vertebroplasty and kyphoplasty should be done within eight weeks of the acute fracture for the best chances of cure.

How should I prepare for Vertebroplasty & Kyphoplasty procedure?

After the compression fracture is diagnosed, it would then be established if it is a candidate for vertebroplasty or kyphoplasty. A medical examination may involve some of the following:

Physical checkup
Diagnostic scanning
Blood test
X-rays of the spine
Radioisotope bone scan
MRI
CT

You might be administered bone-building drugs when undergoing treatment.

Let your doctor know about all your medicines, herbal supplements, allergies, especially to local anesthetic, general anesthesia or contrast materials. Your doctor could ask you to stop taking aspirin, NSAIDs, or blood thinners before your procedure.
Women should inform their doctor and technologist if she is pregnant. Doctors will avoid much of the testing that is normally done in pregnant women to avoid exposure to radiation from the fetus. If an x-ray is ordered, the physician will do everything possible to minimize exposure to the baby. For more information on pregnancy and x-rays, please go to the Radiation Safety page.
This will require you to have blood drawn for tests before the procedure to determine whether your blood is clotting normally.
You might be allowed to take your usual medications with sips of water or clear liquid up to six hours before the procedure. Avoid drinking juice, cream, and milk. Your doctor will issue strict guidelines.
Except for any blood pressure medication, you should take your oral medications on the day of your scheduled procedure. These can be taken in small sips of water in the morning.
Your doctor may ask you to abstain from food and liquids for some time before your procedure, except for medications.
Plan for a ride home after your procedure.
The nurse will bring you a hospital gown to wear during your procedure.

How does the procedure work?

Bone fragments develop when the vertebra cracks or breaks. This leads to pain when the fragments grind against each other or spill into the spinal cord.

Vertebroplasty is a procedure in which a cement mixture is injected into the bone to fuse the fragments and strengthen the vertebra to manage pain.

First, the skin is numbed with a local anesthetic. Then under imaging guidance, the hollow needle or trocar is advanced through the skin into the vertebral body for injection of the cement mixture into the vertebra.

In kyphoplasty, after the skin is locally numbed, the fractured vertebra is entered through the trocar with a balloon placed inside inflated to create a cavity for cement injection and withdrawn before injecting cement into the cavity thus formed by the balloon.

How is the procedure performed?

Vertebroplasty and kyphoplasty are typically performed by an interventional radiologist or neuroradiologist trained in minimally invasive procedures using image guidance, usually in an interventional radiology or neuroradiology suite, but sometimes done in the operating room.
This procedure is usually performed as an outpatient. However, patients may be admitted to the hospital after the procedure. Ask your doctor if you will need to stay overnight in the hospital.
The doctor or nurse will attach monitors that may track your heart rate, blood pressure, oxygen level, and pulse.
A nurse or technologist will insert an intravenous (IV) line into a vein in your hand or arm to administer a sedative. This procedure may employ moderate sedation. It does not involve the use of a breathing tube. General anesthesia is required by a minority of patients.
Your doctor might prescribe drugs that can be administered to you to avoid nausea and pain and also antibiotics in case of any infection.
You will be positioned lying down for the procedure.
The area where the hollow needle, or trocar, will be passed through will be shaved and cleansed with a cleaning solution and dressed with a surgical drape.
A local anaesthesia is injected into the skin and the deeper tissues near the break.
A very minor incision of the skin will be done at the area.
The trocar is passed through the muscles of the back with the help of x-ray images, up to the point that it makes contact with the fractured vertebra's end.
For a vertebroplasty, orthopedic cement is injected. Medical-grade cement hardens fast, typically within 20 minutes. The trocar is withdrawn after the cement has been injected.
In kyphoplasty, after the inserted balloon tamp by the needle, the balloon is inflated to create a hole or cavity. Then, the balloon is withdrawn and bone cement injects through the cavity created by the balloon.
X-rays and/or a CT scan may be performed at the end of the procedure for checking the flow of the cement.
The doctor will press on the area to stop any bleeding and put a bandage over the incision site. No stitches will be used.
It can be performed in less than an hour. More time will be needed if this treatment is being done on more than one vertebral level.
The IV line will be discontinued before leaving the hospital by the doctor or nurse.

What will happen during the treatment?

A doctor or a nurse will place sensors to measure heart rate and blood pressure. It is also accompanied by slight pinching when the needle is introduced into the vein for the IV line with local anesthetic injection. Sedation leads to relaxation and comfort, and the area for treatment may be cleaned, shaved, and numbed. A person might feel tapping because the trocar advances in the bone. Patients who have undergone the procedure are not allowed to drive back home but can be driven if they have their place nearby. They must start slowly increasing their activities and return to usual medications. Pain relief is usually swift in that pain is likely to fade within two to three days. A patient will most probably be sore right at the point where the needle was introduced after the procedure but can use an icepack to reduce the soreness.

Who interprets the results and how will I get them?

You will probably be able to walk about an hour after the procedure. Often, by then, the interventional radiologist is able to let you know that the procedure technically went well.

Your interventional radiologist may make a recommendation for a follow-up visit.

This appointment may include some physical examination, imaging procedures (exam(s)), and blood test. On your follow up visit, advise your physician if you have had any discomforts or side effects.

What are the advantages vs. risks?

Advantages

Vertebroplasty and kyphoplasty can assist in improving the functional potential of a patient and make it possible for the patient to return to the same level of functioning as before without receiving any form of physical therapy or rehabilitation.
These interventions are effective for eliminating the pain caused by a vertebral compression fracture; most patients experience significant improvement within days or very shortly after intervention. Most patients become symptom-free.
Within a few days after receiving vertebroplasty, up to 75 percent of patients regain lost mobility and are more energetic in the fight against osteoporosis. The bedridden patients, who could not stand on their feet and walk earlier, can now stand up and walk after the procedure. This reduces their chance of contracting pneumonia significantly. More physical activity builds more muscle strength, encouraging mobility .
Vertebroplasty and kyphoplasty are most often safe and successful treatments.
No surgical incision is required-a tiny nick in the skin that does not require stitches.

Complications

Any invasive procedure carries a risk of infection. Infection severe enough to require antibiotic treatment seems to occur less than once in every 1,000 times.
A tiny amount of orthopedic cement can leak from the vertebral body. This normally does not cause a significant problem, other than in a potential dangerous location such as the spinal canal or the blood vessels of the lungs.
Other complications can be infection, bleeding, increased back pain, and neurological symptoms like numbness or tingling. Paralysis is rare.
About 10 percent of patients can have further compression fractures following vertebroplasty or kyphoplasty. If this occurs, patients tend to remain pain-free for some days but then are followed by recurrent pain.
Low possibility of Allergic reactions from the medications.

Why Tender Palm Super Speciality Hospital for Vertebroplasty & Kyphoplasty in Lucknow, India?

Tender Palm Hospital has the most experienced spine surgeons provides Vertebroplasty & Kyphoplasty in Lucknow, India. We provide advanced spinal care with modern surgical facilities and a medical team. Our focus on patients ensures safety, precision, and faster recovery. This makes us one of the best hospital for Vertebroplasty & Kyphoplasty in Lucknow, India.