Have you been diagnosed with a spinal fracture or a compression fracture? These spinal column issues can be extremely painful. Even worse, they may result in permanent deformity. If treated early with a minimally invasive procedure called kyphoplasty, you may be able to restore height to the spine. This, in turn, may lead to significant pain relief, reduced deformity, and getting back to doing the things you love.
Your spinal column is composed of 33 bones known as vertebrae. It expands from the base of your skull to your tailbone. These vertebrae protect the spinal cord, support the body, and absorb shock during everyday movements. A spinal compression fracture occurs when one or more of the vertebrae collapses. When the front of the vertebra—known as the vertebral body—loses at least 15 percent of its height, it is considered a compression fracture.
Compression fractures generally occur in the thoracic spine (or upper back). However, the lower back (or lumbar spine region) is also prone to compression fractures.
Too much pressure on a vertebra—usually when bending forward while enduring excessive pressure—can cause compression fractures. Those suffering from osteoporosis—a disease that thins out bone tissue—are more likely to develop this condition. In fact, those with osteoporosis may suffer compression fractures during everyday activities.
Falling, car accidents, and other traumas may also cause compression fractures in normally healthy individuals. In fact, the force of these incidents may stress a vertebra past its breaking point.
It’s also worth noting that compression fractures that seem to come virtually out of nowhere can point to cancer. Metastatic disease—when cancer cells spread to other areas of the body—is common in the bones of the spine.
When the spinal column suffers a compression fracture, it can lead to painful—even debilitating—conditions. Kyphoplasty can be helpful in restoring the height of the vertebra, stabilizing the bone, and reducing pain and other symptoms.
The procedure itself is fairly straightforward. Prior to the operation, local anesthesia is typically administered. However, in some cases, general anesthesia may be used.
First, you will be positioned on an operating table while lying on your stomach.
Then, your doctor will make a small incision near the site of your compression fracture. Next, your surgeon will insert a narrow tube into the incision. Guided by a small camera—known as a fluoroscope—the tube will extend into the back of the affected vertebra.
Once the tube is properly placed, your doctor inserts a special balloon through the tube and into the vertebra. Gently, the balloon inflates. This, in turn, elevates the collapsed bone and creates an opening in the vertebra. The balloon is then removed. Next, the opening is filled with a cement-like substance called polymethylmethacrylate (PMMA). The tube is removed while the PMMA dries. In many cases, it only takes a few minutes for the PMMA to harden.
The incision is then closed up and bandaged. You will be relocated to a recovery room shortly afterward for monitoring until the anesthesia wears off. Most patients spend a day or two in the hospital after undergoing kyphoplasty for monitoring.
The actual kyphoplasty procedure takes about an hour—sometimes more if multiple vertebrae have been compressed.
You may have heard that vertebroplasty also helps those with spinal compression fractures. So what is the difference?
Actually, the two procedures are very similar. The key difference between kyphoplasty and vertebroplasty is the small balloon used in kyphoplasty. This balloon helps to restore vertebral height before the cement is placed. Vertebroplasty, in contrast, does not use this special balloon.
Believe it or not, this small balloon may actually make a big difference. The balloon creates less pressure on the vertebra during the addition of PMMA. In turn, this prevents a phenomenon known as extravasation—the leaking of cement beyond the vertebra. It also restores the vertebral body up to 97 percent of its original height.
Both procedures are relatively safe and effective with few complications. If it is suggested for you to receive vertebroplasty, however, you may want to talk to your doctor or request a second opinion about the benefits of kyphoplasty.
Repeated loading of cement (multiple procedures in the same area), however, may make both kyphoplasty and vertebroplasty less effective.
As mentioned in the previous section, adding the element of the small balloon reduces pressure on the vertebra during the procedure. Kyphoplasty outcomes generally demonstrate more vertebral body height restoration and fewer opportunities for the cement to leak out into other areas of the body.
Kyphoplasty is a minimally invasive procedure of the spine. By using a smaller incision and tiny surgical tools, you can expect several advantages of kyphoplasty over traditional procedures, including:
After surgery, you will be relocated to a recovery room while the anesthesia wears off. Generally, most people will be able to return home the day after the procedure. Driving right after kyphoplasty, however, is not advised.
The pain relief you experience may be immediate or take a couple of days. You will probably experience some soreness at the site of the incision, however. Ice and over-the-counter pain medications can help to relieve any discomfort.
The first day or so after surgery you will need to rest. This allows your body to recover. In addition, you shouldn’t attempt to lift anything that causes you to strain. Your doctor will provide instructions about how to take care of the dressing covering your incision.
Follow any aftercare instructions including administering medications to prevent pain, strengthen the bones, or control osteoporosis. Those with osteoporosis tend to benefit from therapeutic exercises to prevent the progression of the disease.
If all goes well, you can expect to resume your normal activities in about six weeks.
As with any surgery, there are inevitable risks. Luckily, kyphoplasty is a relatively safe procedure with few complications. Risks of kyphoplasty include:
Be sure to contact your doctor if you experience any of these symptoms after the surgery.
If you experience chronic back pain, you may wonder if kyphoplasty is right for you. In general, conservative treatments like rest, bracing, physical therapy, and medications may be advised first. If these conservative approaches don’t work, it may be time to schedule an appointment with a pain management specialist.
Time may not always be on your side. Kyphoplasty doesn’t correct an established deformity of the spine. In fact, those suffering from osteoporosis-related fractures should consider kyphoplasty within 8 weeks of the incident. This time frame offers the best chances of successfully restoring vertebral body height.
Osteoporosis affects everyone differently. Some people suffering from this disease may not be good candidates for kyphoplasty. It’s best to request the guidance of a doctor who specializes in spine and pain issues to determine the best available treatment.
Given the importance of your spine, you want to make sure you enlist trusted pain management specialists who have the knowledge, experience, and technology to successfully diagnose and treat your chronic back pain.
Our team at Integrated Pain Specialists has decades of combined experience in treating a variety of spinal conditions. If you’re wondering about the cause of your back pain, looking for a second opinion, or simply want to get your life back, schedule a consultation today!