Vertebroplasty Kyphoplasty
Kyphoplasty/vertebroplasty are techniques used for treating vertebral compression fractures, small breaks in the thick mass of bone that makes up the front part of the vertebra (called the vertebral body). Vertebral body fractures lead to the collapse or compression of a vertebra, causing the spine to shorten and curve forward. This can result in pain and a kyphotic (hunched-over) deformity. Thinning of bones, or osteoporosis, is the main cause of vertebral compression fractures. Pathologic fractures related to spinal tumors may also be a cause of fractures.
During the procedures, the patient will lie on his or her stomach. The doctor will then insert a hollow needle, called a trocar, through the skin and into the vertebra. A type of X-ray, called fluoroscopy, is used to guide the trocar into proper position.
Once the trocar is in place, either cement (vertebroplasty) or an inflatable balloon-like device (kyphoplasty) are inserted into the vertebra through the trocar. During a kyphoplasty, as the balloon is inflated, it opens up a space to be filled with bone cement. In addition to stabilizing the vertebra and relieving pain, kyphoplasty/vertebroplasty attempt to restore the height of the vertebra, thereby straightening out the spinal curve.
Over the past two decades, the two surgical procedures vertebroplasty and Kyphoplasty for the spine has emerged as a central role of treatment for vertebral compression fractures. Relatively both are new treatment techniques for the pain caused due to vertebral body compression fractures but differ in the treatment procedure. Decompression and fusion are the principle treatment options used to treat these compression fractures before these procedures introduced.
What Is Kyphoplasty?
Kyphoplasty is a surgical intervention developed to treat acute vertebral compression fractures, to stabilize the spinal bone, correction of focal vertebral kyphosis, to restore the vertebral body height that was lost due to the compression fracture. Kyphoplasty is a kind of Vertebral Augmentation done (pinhole surgery) under general anaesthesia.
What Is Vertebroplasty?
Vertebroplasty is a popular outpatient procedure or a daycare procedure performed to treat compression fractures of the spine. After the procedure, 90% of the patients got relief from pain within 24 to 48 hours. It is a minimally invasive procedure (Pinhole procedure )and is considered low risk.
Goals:
• To stabilize the spinal fracture.
• To alleviate pain caused by the fracture.
What is the procedure:
Typical vertebroplasty involves the following steps
The patient is taken to OT and given local anesthesia over skin or light sedation sometimes.
• A biopsy needle is guided into the fractured vertebra, under fluoroscopy guidance, through a small puncture in the patient’s skin.
• Specially formulated acrylic bone cement is injected under pressure directly into the fractured, filling up the spaces within the bone. This makes a type of internal cast (a cast within the vertebra) to stabilize the vertebral bone.
• The needle is removed and the cement hardens quickly (within 10 minutes), sealing the fragments of the fractured vertebra and stabilizing the bone.
• The small skin puncture is covered with a bandage.
• Shortly after the cement has hardened, the patient is free to leave the medical facility and can go home the same day.
Recovery from Vertebroplasty:
• The patient is usually advised to rest for at least 24 hours.
• Activities may be increased gradually and most regular medications can be resumed.
• Many patients undergoing percutaneous vertebroplasty experience 90-100 percent, reduction in pain within 24-48 hours. Their ability to carry daily activities increases shortly thereafter.