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For many years the standard treatments for compression fractures have included pain medications, bed rest, and spinal bracing. Surgical treatment is rarely necessary. For most people, these treatment options can usually treat the injury, and recovery will be complete.
However, many patients are left at high risk for additional fractures, and recovery could be slow. Today we have another treatment option for compression fractures called kyphoplasty that not only repairs the injury but also restores alignment and helps prevent future problems. The procedure is proven and in some case a patient can return to normal activity the same day.
Kyphoplasty is used for patients who meet the following criteria *:
Kyphoplasty is a minimally invasive procedure that uses orthopedic cement or new bone substitute materials to “rebuild” the vertebral space lost as a result of the compression fracture and return it to its original height. The procedure also relieves pain and stabilizes the vertebrae to prevent future injury.
Kyphoplasty is performed under local or general anesthesia. The physician makes a small incision in the skin of the back and, using image guidance x-ray technology, threads a narrow tube through the skin to the fractured vertebrae. A special balloon, called a bone tamp, is then inserted through the tube into the vertebral space and gently inflated, restoring the space to the desired height. Once the appropriate height has been restored, the balloon is removed and the space is filled with orthopedic cement called PMMA (Polymethylmethacrylate).
This cement hardens and repairs the fracture as well as provides strength and stability to the vertebrae, restores height, and relieves pain. Recently, in some cases a bone substitute has been used for this purpose, but long term results are not known. On average, a kyphoplasty procedure takes about 30 to 45 minutes per fracture treated.
In addition to repairing the compression fracture, restoring height to the spinal column, and relieving pain, kyphoplasty has the following additional benefits:
Another important benefit of this procedure is that it can prevent future fractures by stabilizing the vertebrae, thereby preventing the onset or worsening of severe spinal deformity. While it works best for recent fractures, some patients with older injuries may also benefit. Kyphoplasty is not appropriate for severe spinal deformities caused by repeated compression fractures or fractures that are the result of cancer or injuries sustained in auto accidents or falls.
As with any surgical procedure, kyphoplasty does have potential risks and complications.
The most common complication is cement leaking out of the vertebra before it hardens. Other risks include cement leaking into the spinal canal, causing pain and neurological problems. In rare cases, pulmonary embolism of the lungs and even death have been associated with this procedure. It is important that the procedure is done by a spine surgeon familiar with treating this rare complication, if it occurs. One of our Princeton Brain & Spine neurosurgeons will help you assess the risks and benefits to kyphoplasty.
We perform kyphoplasty at our practice. Most of our patients report a significant reduction in pain within 48 hours of the procedure. They are able to quickly return to their normal activities, often the same day as the procedure. However, this procedure is not appropriate for everyone. If you have a compression fracture, you will meet with one of our fellowship trained neurosurgeons to see what treatment options are best suited for your particular situation and diagnosis.
* Kyphoplasty: indications, contraindications and technique NIH / Pubmed
LastUpdate: 2018-01-31 09:17:19