Vertebroplasty and kyphoplasty
What is vertebroplasty?
Vertebroplasty is a minimally invasive percutaneous procedure used to treat painful vertebral fractures in the spine, usually caused by osteoporosis, which consists of filling the broken vertebra with cement and a contrast medium in order to stabilize the vertebral compression fracture to stop its painful movements.
When is vertebroplasty performed?
Vertebroplasty is recommended in cases of vertebral fracture when less invasive treatments such as bed rest, bracing or analgesics have not been effective.
The procedure can be performed immediately in patients with problematic pain requiring hospitalization or in case of conditions that limit bed rest and analgesics.
Vertebroplasty is a procedure that in more than 90% of cases manages to reduce acute pain secondary to vertebral fracture, allowing a reduction in medication and a faster resumption of basic activities of daily living.
What does vertebroplasty consist of?
The procedure involves injecting a special medical-grade acrylic cement mixture into the fractured vertebra to relieve pain and restore mobility.
It is an approximately 1-hour procedure that is usually performed under sedation or general anesthesia and can be done on an outpatient basis or with a hospital stay.
Trocars and cannulae are used and placed under radiological control with the image intensifier (scopia) in an anterior-posterior (AP) and lateral projection. Cannulas are introduced into the vertebra through the pedicles injecting the cement mixed with contrast medium to fill the fractured vertebra.
What is the difference between vertebroplasty and kyphoplasty?
Vertebroplasty and kyphoplasty are two similar procedures used to treat vertebral compression fractures.
In vertebroplasty, bone cement is injected directly into the fractured vertebra through trocars or cannulas.
Kyphoplasty is basically the same, with a previous step in which a balloon is inserted into the fractured vertebra to create a space that, once inside, will expand to reduce the kyphosis resulting from vertebral collapse or subsidence. The central void created after removal of the balloon or device is filled with the stabilizing material (cement).
The choice between the two procedures will depend on the patient’s individual needs, which will be advised by his or her spine surgeon.
What are the risks of vertebroplasty or kyphoplasty?
Both are generally well tolerated procedures with a minimal complication rate (less than 4%[1]). The main risk is a potential leakage of the injected cement, although thanks to the contrast medium that is mixed with the cement, the surgeon can detect it in time.
What is the postoperative period after vertebroplasty or kyphoplasty?
The postoperative period for both procedures requires a short hospital stay with relative rest and a gradual return to normal activities following the instructions of your spine surgeon.
[1] Wong C, McGirt MJ, Vertebral compression fractures: a review of current management and multimodal therapy. J Multidiscip. Healthc. 2013; 6: 205-14