These two spinal treatments are separate approaches to the same goal, which is the stabilization of a spinal fracture to provide pain relief. Each involves the injection of special bone cement to assist in providing a stable foundation for spinal fractures. Each procedure is a short, low-risk, outpatient technique designed to provide relief.
What will vertebroplasty and kyphoplasty treat?
Any patient who has had a spinal compression fracture, also known as a vertebral compression fracture, can potentially find relief with either of these procedures at a Tampa pain center. These are typically performed for those patients who are over 60 and who have had osteoporosis become a pain complication requiring treatment. Those patients who have suffered a compression fracture due to cancer can also potentially benefit from one of these procedures.
On the subject of compression fractures, it is possible for a patient to have one and not even know it. This is because the fracture can be both painless and clinically silent. The opposite is also possible, as these fractures may cause significant pain to the area surrounding the broken spinal bones. Muscle spasms may occur in the back while the body attempts to stabilize the fracture.
How are vertebroplasty and kyphoplasty performed?
The purpose of each procedure is the same: to reduce the pain of a compression fracture and provide stabilization to the spine. The differences between the two are simply variations in the procedural approach.
Vertebroplasty is performed with the insertion of a catheter into the broken vertebrae through a minimally invasive incision. This insertion is monitored through fluoroscopy, a technique using X-rays taken in rapid succession to form a real-time picture. Once the catheters are properly placed inside the fracture, a bone cement solution will be injected.
This will be allowed time to harden and provides stabilization for the spine. This cement is not designed to heal the fracture; it is entirely for stabilization and pain relief. Increased function of the spine once stabilized is another typical purpose for this treatment.
Kyphoplasty is also performed as a minimally invasive outpatient procedure for the patient. Catheters will be inserted using fluoroscopy in this procedure as well, but at this point is where the technique differs.
A saline-inflated balloon will be placed into the area of the fracture. This is done in order to force the broken bone pieces aside to provide a larger, cleaner area for the insertion of the bone cement. The balloons are removed prior to the insertion of cement, having served simply to clear a larger opening for the cement to be filled into.
The biggest difference between these two procedures is how the cement is injected. During vertebroplasty, the cement is injected under high pressure in order to flow around any potential obstructions – such as fractured bone pieces. Kyphoplasty adds an extra step in the procedure to allow for the injection of the cement under low pressure. There is currently no clinical evidence stating which technique is superior.
How well do vertebroplasty and kyphoplasty work?
Each of these treatments can provide great benefit to a patient who is having pain complications as a result of a fracture. If pain is coming from an area other than the fracture site, these procedures may not provide benefit. To be effective it should be administered within 2-3 months after a fracture. That being said, over 90% of patients who undergo one of these procedures have significant pain relief.
Each of these is a one-time treatment of a fracture that results in a permanent alteration to the spine (hardened cement). It is possible for a fracture to occur at a different level of the spine, but this can be treatable by subsequent vertebroplasty or kyphoplasty.
What are the risks of vertebroplasty and kyphoplasty?
The risk is low for these procedures, but still present. There is the standard small chance of infection due to this being a needle-based treatment. In very rare cases, the neurologic injury may occur. It is possible for the liquid cement being injected to leak out into the other areas of the body, where it may potentially envelop a nerve or a portion of the spinal cord.
What is the bottom line with vertebroplasty and kyphoplasty?
If applied in the proper timeframe after a fracture, each of these can provide great benefit with very little risk to the patient.
