Vertebroplasty | Kyphoplasty

What is Vertebroplasty | Kyphoplasty?

Vertebroplasty and kyphoplasty are minimally invasive spine procedures designed to treat the pain and other symptoms of vertebral compression fractures. Vertebral compression fractures (compression fractures of the spine) most often are caused by osteoporosis, which is a weakening of the bones.

The procedures are almost always done on an outpatient basis. Patients are numbed with local anesthetic, and conscious sedation is used to keep the patient relaxed and comfortable.

In vertebroplasty:

• The physician advances a specialized needle into the fractured vertebrae under live X-ray guidance.
• Once the needles are placed into the front part of the vertebrae, a specialized bone cement is injected into the vertebrae.
• The cement then hardens.
• The cement acts as an internal cast for the vertebrae, with the hopes of decreasing pain and preventing further vertebral collapse.

In kyphoplasty:

• The physician advances a specialized needle into the fractured vertebrae under live X-ray guidance.
• A small cavity is created inside the vertebral body by inflating a small balloon.
• This space is filled with special cement.
• The cement then hardens.
• The cement acts as an internal cast for the vertebra, with the hopes of decreasing pain and preventing further vertebral collapse.
• In some cases, kyphoplasty may also be able to restore some lost height in the vertebrae.

Recovery is fairly simple with no bracing and minimal limitations.

What is the difference between vertebroplasty and kyphoplasty?

During kyphoplasty, prior to the cement being injected, a small balloon is placed through the needle into the vertebral body. Once in the vertebra, the balloon is inflated to create a small cavity within the vertebra. This cavity is then filled with cement. Your physician will determine which procedure is necessary.

Overview of vertebroplasty and kyphoplasty

Here’s what to expect during vertebroplasty or kyphoplasty procedure:

• Before the procedure, you’ll get an intravenous (IV) line placed in your arm, so you can receive fluids and medicine during the procedure.
• You will lie face down on a special X-ray table.
• The skin over the fractured area is cleaned, prepared, and numbed.
• You may be given medicine to make you feel relaxed and comfortable.
• Using fluoroscopic (X-ray) guidance, your physician will identify the fracture in your spine.
• The tissues behind the fracture are numbed.
• Your doctor inserts a thin needle under X-ray guidance and injects bone cement until the vertebral body is filled.
• Although the cement hardens rapidly, you will lie flat for one hour after the procedure to ensure that the cement is completely hardened.

Preparing for vertebroplasty or kyphoplasty

• Follow the specific instructions given to you by the nurses at the procedure center.
• While the procedure usually takes around 30 to 45 minutes to perform, you should allow for at least one to two hours at the procedure center.
• You need to arrange for a driver to be present and take you to and from the medical facility. If you do not have a driver with you, we may have to reschedule your procedure.
• If you are taking prescription blood thinners such as Coumadin (warfarin), Ticlid (ticlopidine), or Plavix (clopidogrel bisulfate), among others, please inform your patient care coordinator. These medicines will need to be stopped before the procedure, but only after you receive permission from the doctor who is prescribing these medicines.
• If you are on high doses of aspirin (more than two per day), tell your doctor’s patient care coordinator.
• Tell your doctor’s patient care coordinator if you have a pacemaker.
• If you develop a fever, night sweats, or an active infection before your procedure, your procedure will need to be rescheduled. Please contact our office at (651) 968–5201 immediately to let us know about the symptoms you’re experiencing.

After the procedure

• Follow the specific instructions given to you by the nurses at the procedure center.
• You will lie flat for one hour after the procedure.
• Plan to rest for the next one to two days. You may resume light activity that is comfortable for you.
• Keep the skin puncture sites clean and dry. Remove any bandages the next day and keep the skin open to air.
• For discomfort, apply ice packs to the puncture site for 15 minutes several times a day.
• Do not soak in a tub for 24 hours after the procedure. Thereafter, you may soak in a warm tub or under a warm shower two to three times per day for comfort. After each soak, pat the overlying skin dry with a clean towel.
• Report any signs of infection or other unusual symptoms to our office, including:
  • Redness and warmth at the injection site
  • Increasing pain
  • Swelling or drainage at the injection site
  • Chills, night sweats, or fever that reaches above 100° F
• Keep a record of your pain and symptoms and report your results as instructed by your doctor’s patient care coordinator.

You may experience an increase in pain for up to two weeks after the procedure. This discomfort should gradually disappear as you heal. After the procedure soreness is gone and you begin to resume normal activity, you will be able to evaluate any improvement in your pain. Your pain relief benefits from vertebroplasty or kyphoplasty may be not fully known until four weeks after the procedure.

Potential risks of vertebroplasty and kyphoplasty

Vertebroplasty/kyphoplasty is a relatively safe, minimally invasive procedure. The risks associated with the procedure include:

• Allergic reaction
• Bleeding
• Infection
• Pain at the injection site
• Nerve injury
• Damage to nearby areas from the needle placement
• Cement leaking out of the vertebrae

If your procedure includes sedation

• You should have no solid foods for six hours before your procedure.
• You may have clear liquids up to two hours before your procedure. Examples include:
• • Water
  • Broth
  • Clear fruit juices such as apple, cranberry, and grape juice (no pulp)
  • Tea, black coffee with no cream
  • Carbonated beverages

• Nothing by mouth, including throat lozenges, mints, and all hard candy, for two hours before your procedure.
• No gum for two hours before your procedure.
• You must have a responsible adult arrive with you to our facility and drive you home. If you use a taxi or volunteer ride service, you still must have a responsible adult with you in order to help take care of you after your procedure.
• Please take your regular medications the day of your procedure, especially any heart, diabetes, or blood pressure medications.

Summit Orthopedics offers comprehensive spine expertise

Summit’s spine care team is recognized by the National Committee for Quality Assurance for the comprehensive expertise of our patient-centered care. Our back specialists diagnose spine problems and design custom treatment plans built on a conservative, nonsurgical approach. Most patients find relief through treatments including guided injections, specialized physical therapy, biofeedback, exercise, activity modification, and medication. When conservative care does not relieve symptoms, our highly skilled surgeons offer proven, evidence-based surgical options. Together with you, we will determine the right course of action.

Start your journey to a healthy spine. Find your spine expert, request an appointment online, or call us at (651) 968–5201 to schedule a spine consultation.

Summit has convenient locations across the Minneapolis-St. Paul metro area, serving Minnesota and western Wisconsin. We have state-of-the-art centers for comprehensive orthopedic care in Eagan, MN, Vadnais Heights, MN, and Woodbury, MN, as well as additional community clinics throughout the metro and southern Minnesota.

More resources for you

• Visit our Spine Exercise Library for options to help ease neck and back pain
• See Summit’s treatment options for neck, back, and spine care
• Check out additional information on Summit’s approach to spine care