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Kyphoplasty

By

Sarah Lewis, PharmD

What is kyphoplasty?

Kyphoplasty is a minimally invasive procedure that treats vertebral compression fractures. A vertebral fracture causes the vertebra to collapse and compress, causing pain and a hunched posture. The procedure involves inserting a balloon into the fractured vertebra to create a cavity. The cavity is filled with an acrylic cement mixture. This restores the height and shape of the vertebra and relieves pain.

Kyphoplasty is most successful in treating vertebral fractures, correcting spine deformity, and restoring vertebra height within the first three months of the injury. 

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Kyphoplasty is a minor procedure, but it still involves some risk. It is only one method used to treat vertebral compression fractures. Discuss all of your treatment options with your doctor to understand which options are right for you.  

Why is kyphoplasty performed? 

Your doctor may recommend kyphoplasty to treat vertebral compression fractures. Your doctor may only consider kyphoplasty for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your treatment options and consider getting a second opinion.

Vertebral compression fractures are often related to the following conditions: 

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  • Cancer, including bone cancer and multiple myeloma

  • Osteoporosis, which is a loss of bone mass and destruction of bone tissue that weakens the bones and makes them more likely to break. This is the most common cause of vertebral compression fractures.

  • Trauma, including spinal injuries

Who performs kyphoplasty?

The following specialists commonly perform kyphoplasty:

  • Interventional radiologists specialize in using imaging technology, such as X-rays and MRI, and catheter-based procedures to diagnose and treat many diseases.

  • Neuroradiologists specialize in diagnosing and treating diseases and conditions of the brain, spine, head, neck and nerves using radiation and other imaging technologies.

  • Neurosurgeons specialize in the medical and surgical care of people with diseases and conditions of the brain and nervous system.

  • Orthopedic surgeons specialize in treating problems of the bones and joints.

How is kyphoplasty performed?

Your kyphoplasty will be performed in a hospital or outpatient setting. It is a minor procedure that involves the following steps:

  1. You will dress in a patient gown and lie face down on a procedure table.

  2. Your team will insert an IV to provide fluids and medications.

  3. Your team will attach devices to monitor your vital signs.

  4. You will receive a sedative to relax you. You may have general anesthesia if you are in extreme pain from your vertebral compression fracture. General anesthesia is a combination of intravenous (IV) medications and gases that put you in a deep sleep. You are unaware of the procedure and will not feel any pain.

  5. You will lay face down to expose your spine. You will have pillows and supports to provide comfort and help keep you in position.

  6. Your team will shave, clean and cover the affected area of your spine with a surgical drape.

  7. Your doctor will numb the skin and muscles with an injection of local anesthetic. Some people have regional anesthesia, also known as a nerve block. It involves injecting an anesthetic around certain nerves to numb a large area of the body.

  8. Your doctor will insert a needle through your skin and into your fractured spinal vertebra. Your doctor will use real-time X-ray guidance to place the needle in the proper place.

  9. Your doctor will insert a balloon through the needle and inflate it to create a cavity in your vertebra. Then, your doctor will withdraw the balloon, inject medical grade cement into your vertebra, and remove the needle. The cement hardens within 15-20 minutes.

  10. Your doctor repeats the process for each fractured vertebra.

  11. Your team may take additional x-ray or CT images once the injections are complete.

Will I feel pain with kyphoplasty?

Your comfort and relaxation is important to both you and your care team. You may feel a brief pinch or prick during IV insertion. You may also feel brief stinging during injection of the local anesthetic in the skin of your back. You may feel pressure when your doctor inserts the needle. Take a few long, deep breaths to help yourself relax. Tell your doctor if any discomfort does not pass quickly. 

What are the risks and potential complications of kyphoplasty?

Complications after kyphoplasty are not common, but any medical procedure involves risk and potential complications. Complications may become serious in some cases. Complications can develop during the procedure or recovery. Risks and potential complications of kyphoplasty include: 

  • Anesthesia reaction, such as an allergic reaction and problems with breathing

  • Bleeding

  • Cement leakage into your spinal canal where your spinal cord is located

  • Exposure to ionizing radiation, which may be harmful in excessive doses. Your care team follows strict standards for X-ray techniques and will use the lowest amount of radiation possible to make the best images.

  • Increased back pain

  • Infection

  • Nerve or blood vessel damage

  • Paralysis (extremely rare)

Reducing your risk of complications

You can reduce the risk of certain complications by: 

  • Following activity, exercise and lifestyle restrictions and recommendations

  • Following instructions after the procedure exactly

  • Informing your doctor if you are nursing or if there is any possibility of pregnancy

  • Keeping all scheduled appointments

  • Notifying your doctor immediately of any concerns, such as bleeding, fever, or increase in pain

  • Taking your medications exactly as directed 

  • Telling all members of your care team if you have any allergies

How do I prepare for my kyphoplasty?

You are an important member of your own healthcare team. The steps you take before your kyphoplasty can improve your comfort and outcome. You can prepare for kyphoplasty by:

  • Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Arranging for a ride home after your procedure

  • Following exactly any instructions about eating and drinking before a kyphoplasty

  • Getting all necessary laboratory testing completed prior to your procedure

  • Leaving jewelry, metal objects, credit cards, and other valuables at home

  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners.

Questions to ask your doctor

Preparing for kyphoplasty can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before your procedure and between appointments. 

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Why do I need kyphoplasty?

  • Are there any other options for treating my condition?

  • Why is kyphoplasty the best option for me?

  • How long will the procedure take? When can I go home?

  • What restrictions will I have after the procedure? When can I return to work and other activities?

  • How will you treat my pain?

  • What kind of assistance will I need at home? Will I need a ride home?

  • How should I take my medications?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

What can I expect after my kyphoplasty?

Knowing what to expect after kyphoplasty can help you get back to your everyday life as soon as possible. 

How will I feel after kyphoplasty?

Some people get immediate pain relief from kyphoplasty. However, you may have temporary increased back pain or pain at the injection site for several hours. To reduce discomfort, apply ice packs and take your pain medication as directed by your doctor. Complete pain relief may take up to three days. Tell your doctor if your pain is not well controlled by your medication because it can be a sign of a complication.

When can I go home?

You will need to lie flat for about an hour after kyphoplasty to allow the cement to harden thoroughly. You will stay in the outpatient facility or hospital for one to two hours, but an overnight hospital stay is sometimes necessary. You will likely be on bed rest for the first 24 hours following your kyphoplasty. You may need to avoid strenuous activities for some time, but can usually resume normal activities the following day.

When should I call my doctor?

It is important to keep your follow-up appointments after kyphoplasty. Contact your doctor for questions or concerns between appointments. Call your doctor right away or seek immediate medical care if you have:

  • Bleeding

  • Fever

  • Inability to move a body part

  • Numbness or weakness

  • Pain that is not controlled by your pain medication

Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Sep 21, 2016

© 2017 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

View Sources

Medical References

  1. Balloon Kyphoplasty. Medtronic. http://www.kyphon.com/us/physician.aspx?contentid=61
  2. Getting Kyphon Balloon Kyphoplasty. Medtronic. http://www.medtronic.com/patients/spinal-fractures/getting-the-device/index.htm
  3. Kyphoplasty. Johns Hopkins. http://www.hopkinsmedicine.org/healthlibrary/test_procedures/orthopaedic/kyphoplasty_135,36/
  4. Kyphoplasty. Mayo Clinic. http://www.mayoclinic.org/vertebroplasty/kyphoplasty.html
  5. Kyphoplasty/Vertebroplasty. Cleveland Clinic. http://my.clevelandclinic.org/services/kyphoplasty/hic_kyphoplasty.aspx
  6. Osteoporosis and Spinal Fractures. American Academy of Orthopedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00538
  7. Vertebroplasty & Kyphoplasty. American College of Radiology. http://www.radiologyinfo.org/en/info.cfm?pg=vertebro
  8. Your Balloon Kyphoplasty Medical Team. Medtronic. http://www.balloonkyphoplasty.com/your-balloon-kyphoplasty-medical-team.html

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