Kyphoplasty and vertebroplasty are two similar procedures used to treat compression fractures of the spine. They involve the injection of bone cement into the broken vertebra, which then hardens and provides support to the fracture.
What conditions benefit from kyphoplasty and vertebroplasty?
Fractures of the vertebral body can benefit from kyphoplasty and vertebroplasty.
These fractures can be caused by a wide range of conditions, of which osteoporosis (weakening of the bone) is the most common.
Other conditions that can cause vertebral fractures requiring these procedures include:
Metastatic growth from malignancies
Vitamin D deficiency
Chronic renal disease
Certain drugs have also been identified to cause osteoporosis, and continued intake of the following can contribute to the weakening and fracture of the spine:
Thyroid replacement drugs
What is the difference between vertebroplasty and kyphoplasty?
Vertebroplasty is the procedure in which medical-grade bone cement is injected under fluoroscopic (X-ray) guidance into a fractured vertebra. This procedure can be done under local anesthesia, and is generally an outpatient procedure. This reduces pain by fusing the vertebral fragments into a single block, preventing the pain from the rubbing of these fragments against each other.
It is theorized that the heat produced during the polymerization process also contributes to the healing and relief from pain. Vertebroplasty provides stabilization to the broken vertebra, and the strength from the bone cement can prevent future repeat fractures to the same vertebra.
What are the risks and outcomes of kyphoplasty and vertebroplasty?
Both procedures are well-tolerated by most patients, and will normally improve Vertebroplasty and Kyphoplasty Countyoutcomes. However, these procedures are only recommended after the failure of more conservative options.
It is recommended that in the absence of risk factors for failure of non-surgical management, an initial three-week trial of conservative management be attempted before considering surgery.
Kyphoplasty has been shown to be highly effective in reducing pain from compression fractures, with reductions over 60% in pain scores noted in some studies. Vertebroplasty has also been shown to be effective in alleviating pain from vertebral fractures. The two procedures have comparable outcomes, although it is kyphoplasty that has been shown to offer a higher degree of correction for spinal deformities. Kyphoplasty also results in less leakage of bone cement.
There are always risks associated with surgical procedures, and those undergoing kyphoplasty or vertebroplasty are at risk of infection at the surgical site, intraoperative damage to the surrounding nerves, bone, muscle and other tissues, as well as the risk of bleeding. There is also the risk of adverse effects from leakage or erroneous placement of the bone cement. However, these risks are often minimal and are rarely reported.
Chen AT, Cohen DB, Skolasky RL. Impact of nonoperative treatment, vertebroplasty, and kyphoplasty on survival and morbidity after vertebral compression fracture in the medicare population.J Bone Joint Surg Am. 2013 Oct 2;95(19):1729-36. doi: 10.2106/JBJS.K.01649.
Dong R, Chen L, Tang T, et al. Pain reduction following vertebroplasty and kyphoplasty. Int Orthop. 2013 Jan;37(1):83-7. doi: 10.1007/s00264-012-1709-0. Epub 2012 Nov 11.
Werner CM, Osterhoff G, Schlickeiser J, et al. Vertebral body stenting versus kyphoplasty for the treatment of osteoporotic vertebral compression fractures: a randomized trial. J Bone Joint Surg Am. 2013 Apr 3;95(7):577-84. doi: 10.2106/JBJS.L.00024.