Balloon kyphoplasty is a minimally invasive treatment that can repair spinal fractures caused by osteoporosis, cancer, or benign lesions. Vertebral compression fractures are a common cause of moderate to severe back pain in adults. During the procedure, orthopedic balloons are used to gently elevate the fractured vertebra in an attempt to return it to the correct position. Bone cement is then injected to stabilize the fracture. Balloon kyphoplasty takes up to one hour per fracture level treated. It can be done on an inpatient or outpatient basis, depending on your overall state of health as determined by your physician. Most patients have little discomfort after the procedure, and return to usual activities in 7-10 days.
First, a narrow pathway is made into the fractured bone with a hollow instrument. A small orthopedic balloon is guided through the instrument into the vertebral body. The incision site is approximately 1 cm (1/3 inch) in length.
Next, the balloons are carefully inflated to gently elevate the fractured vertebra in an attempt to return it to the correct position.
Inflation of the balloons creates a cavity (space) within the vertebral body and compacts the soft, inner bone against the outer wall. Once the vertebral body is in the correct position, the balloons are deflated and removed.
The cavity is filled with thick bone cement to stabilize the fracture. The bone cement dries quickly and forms an internal cast that holds the vertebral body in place.
Kyphoplasty is a minimally invasive surgical procedure to treat spinal fractures. Small tubes are placed through punctures in the skin into the fracture, and a balloon is inserted and inflated. The balloon creates a cavity in the vertebral body and helps restore vertebral body height. Bone Cement is injected to fill the cavity and immobilize the fracture. Restoring the height of the vertebral body and immobilizing the fracture stops the pain.
Anyone with back pain due to a spinal fracture may be a candidate. Prior to kyphoplasty, we generally recommend that patients try rest, bracing, and pain medication. More recent fractures(less than 3 months old) generally achieve better results after the procedure.
The principles used by orthopedic surgeons to treat other fractures apply to vertebral fractures. Restoring the vertebral height and placing bone cement to stabilize the fracture is an ideal treatment from an orthopedic surgical standpoint and gives the best long term outcome. Long term reduction in back pain and improved quality of life have been demonstrated in many long term studies. The restoration of vertebral height and alignment is an advantage over vertebroplasty.
A very small incision or puncture is made near the fractured vertebral body. A small tube is guided into the fractured bone using a special real time xray machine called a fluoroscope. A balloon is inserted, inflated, and removed. This realigns the fracture and creates a cavity for the cement. Bone Cement is then inserted into the bone to maintain the alignment and stability. The bone cement hardens in about 15 minutes.
Dr. Savage Jr., Dr. Gullung, and Dr. Savage Sr. are experienced orthopedic spine surgeons who are used to working with bone cement on many other procedures in the operating room. They generally take less than 20 minutes of actual working time to complete a single level kyphoplasty once the patient is positioned and prepared for the procedure.
We use sedation and local anesthesia for most cases. Occasionally patients receive a general anesthetic.
Multiple studies conducted by orthopedic surgeons show excellent pain relief which lasts a long time. Once the vertebral body has cement inside, it usually does not cause any more pain. The same studies also show increased level of function following kyphoplasty. 75% of patients show improved function after the procedure. In our practice, well over 90% of patients experience relief of back pain.
You are usually allowed to leave several hours after the procedure. Overnight stays are not typical. Some soreness around the incision is common. Many patients report minimal or no pain. It is best to rest for 24 hours following the procedure. Keep the incision site clean and dry. No heavy house work or yard work until the doctor sees you 2-3 weeks after the procedure. In our experience, most patients experience fracture pain relief within 48 hours.
Risks associated with kyphoplasty include infection and reactions to anesthesia. Having an orthopedic surgeon who has completed a spine fellowship and does complex spine surgery on a routine basis allows you to receive a very high level of care, and if you do have problems after the procedure, the surgeon can manage those. Non-surgeons are not able to manage most of the potential complications of kyphoplasty, leaving a patient and their family in the hands of someone they may not know, while in a difficult situation. Consult one of our orthopedic spine surgeons for a discussion of the risks of the procedure.
It is best to rest for 24 hours following the procedure. Keep the incision site clean and dry. No heavy house work or yard work until the doctor sees you 3 weeks after the procedure. Usual activities are ok after 5-7 days.
Reduction in back pain, improved quality of life, increase level of function, improvement in mobility, vertebral body height restoration, and a very low complication rate when performed by an orthopedic spine surgeon are the primary benefits of kyphoplasty.
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