When a vertebra breaks or fractures, bone fragments develop. Pain occurs when these fragments slide or rub against each other or protrude into the spinal cord. Kyphoplasty is a procedure used to treat painful compression fractures in the spinal column, which are most commonly a result of osteoporosis. The doctors at Vascular Health Institute in Dallas, TX use image guidance to insert a balloon into the fractured vertebrae to create a space that is then filled with bone cement. About 75% of patients regain lost mobility, and become more active after this procedure.
In kyphoplasty, after numbing the skin locally, a balloon is inserted through the trocar into the fractured vertebra where it is inflated to create a cavity for cement injection. The balloon is removed prior to injecting cement into the cavity that was created by the balloon.
Image-guided, minimally invasive procedures such as vertebroplasty and kyphoplasty are most often performed by a specially trained interventional radiologist in an interventional radiology suite like Vascular Health Institute.
This procedure is often done on an outpatient basis.
You may be connected to monitors that track your heart rate, blood pressure and pulse during the procedure.
A nurse or technologist will insert an intravenous (IV) line into a vein in your hand or arm so that sedative medication can be given intravenously. Moderate sedation may be used.
You may be given medications to help prevent nausea and pain, and antibiotics to help prevent infection.
You will be positioned lying face down for the procedure.
The area through which the hollow needle, or trocar, will be inserted will be shaved, sterilized with a cleaning solution and covered with a surgical drape.
A local anesthetic is then injected into the skin and deep tissues, near the fracture.
A very small skin incision is made at the site.
Using x-ray guidance, the trocar is passed through the spinal muscles until its tip is precisely positioned within the fractured vertebra.
In kyphoplasty, the balloon tamp is first inserted through the needle and the balloon is inflated, to create a hole or cavity. The balloon is then removed, and the bone cement is injected into the cavity created by the balloon.
X-rays and/or a CT scan may be performed at the end of the procedure to check the distribution of the cement.
Pressure will be applied to prevent any bleeding and the opening in the skin is covered with a bandage. No sutures are needed.
This procedure is usually completed within one hour. It may take longer if more than one vertebral body level is being treated.
Your intravenous line will be removed.
Devices to monitor your heart rate and blood pressure will be attached to your body.
You will feel a slight pin prick when the needle is inserted into your vein for the intravenous line (IV) and when the local anesthetic is injected. Most of the sensation is at the skin incision site, which is numbed using local anesthetic. You may feel pressure when the catheter is inserted into the vein or artery.
If the procedure is done with sedation, the intravenous (IV) sedative will make you feel relaxed, sleepy and comfortable for the procedure. You may or may not remain awake, depending on how deeply you are sedated.
The treatment area of your back will be cleaned, shaved and numbed.
During the procedure you will be asked questions related to your comfort. It is important for you to be able to tell your doctor whether you are feeling any pain.
The longest part of vertebroplasty and kyphoplasty procedures involves setting up the equipment and making sure the needle is perfectly positioned in the collapsed vertebral body.
You may feel a tapping sensation during the procedure as the trocar is advanced into the bone.
You may not drive after the procedure, but you may be driven home if you live close by.
You will be advised to increase your activity gradually and resume all your regular medications. At home, patients may return to their normal daily activities, although strenuous exertion, such as heavy lifting, should be avoided for at least six weeks.
If you take blood thinners, check with your doctor about restarting this medication the day after your procedure.
Pain relief is immediate for some patients. In others, pain is eliminated or reduced within two days. Pain resulting from the procedure will typically diminish within two to three days.