What is Kyphoplasty?

Kyphoplasty is a specialized type of pain management used to treat painful compression fractures in the spine. These fractures may have been caused by accidents, osteoporosis, or as the result of diseases such as cancer. Kyphoplasty is often recommended for patients who experience severe or disabling pain that has not responded to bed rest, physical therapy, or pain medications for over two months. Kyphoplasty can also be used to restore vertebral body height lost due to osteoporosis or compression fracture.

About the Procedure

The procedure is performed in a hospital or outpatient setting by an interventional radiologist, either under moderate sedation or under a general anesthetic (deep sedation). The patient lies face down on a table while the doctor inserts a needle directly into the bone of each compressed vertebra, using X-ray fluoroscopy to place it precisely. When the needle is positioned properly, a tiny balloon is passed through the needle into the bone, and then inflated to restore the original height of the collapsed or compressed vertebra. Finally, cement is injected through the needle into the enlarged space to make sure it does not collapse again.

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What To Expect

The procedure can take up to an hour, depending on the number of fractures present. However, in cases of extensive osteoporosis or injury, multiple treatment sessions will be likely. You will lie on your stomach, your blood pressure and oxygen levels will be monitored while you are sedated. A local anesthesia will be used to numb the areas where the needle is inserted. The interventional radiologist will use X-ray fluoroscopy during the procedure to precisely place the needle in each vertebra being worked on, and to measure its proper height once it has been expanded by the balloon.

Results

After the procedure you will rest while your progress and your vital signs are carefully monitored. You will be monitored for a few hours, then released the same day.

Pain relief is immediate in some patients, whereas in others it is reported within 2 days. After resting for a couple of days you can resume your normal activities, but you should avoid strenuous exertion and especially any heavy lifting for at least six weeks.

A Few Of Our Cases

Image A

This image is from a CT scan of the thoracic spine that has been reconstructed in the sagittal plane. The image is viewed as if you are looking at someone fro the side view. The curvature of the spine is accentuated due to multiple small wedge compression fractures of the thoracic spine. This is called kyphosis. The level that is labeled T4 is the one level that has recently fractured.

Image B

On this image from the bone scan that also has been reconstructed in the side view. The bright yellow level is the T4 vertebral body that has recently fractured. This is said to be the "hot" level. New or chronic fractures show up as "hot" on bone scans. Old fractures that have healed do not show up as hot and look like the rest of the spine. This test helps to determine which level may need to be treated.

Image C

This is an early image from the actual kyphoplasty procedure. The patient is laying on their stomach and the images are taken from a side view. the level that needs to be treated has been identified and the guiding cannulas have been placed into the fractured level.

Image D

After the guiding cannulas have been optimally placed, small balloons are inflated in the fractured bone to make space for the cement. The balloons are inflated with contrast so the can be seen under the x-ray camera. Once the cavity has been created, the balloons are deflated and removed.

Image E

This image is after the cement has been injected into the fractured bone. This image is also taken on the side, known as the lateral projection.

Image F