Kyphoplasty

Kyphoplasty surgery is used to stop the pain caused by a spinal fracture, to stabilize the bone, and to restore some or all of the lost vertebral body height due to the compression fracture. Kyphoplasty is a type of Vertebral Augmentation for compression fractures.

Osteoporosis is an epidemic in India and is very common found in post menopausal women and even in old males. It can cause severe back pain and also lead  to fractures, most common is spine, hip, and wrist.There can be spontaneous spinal fractures without any trauma or fall, causing severe back pain and disability.  Multiple fractures can lead to kyphotic spine with a forward bend in the posture, as we observe in many old ladies, walking bending forward.

Steps in Kyphoplasty surgery are as follow:

  1. During kyphoplasty surgery, a small incision is made in the back through which the doctor places a narrow tube. Using fluoroscopy to guide it to the correct position, the tube creates a path through the back into the fractured area through the pedicle of the involved vertebrae.
  2. Using X-ray images, the doctor inserts a special balloon through the tube and into the vertebrae, then gently and carefully inflates it. As the balloon inflates, it elevates the fracture, returning the pieces to a more normal position. It also compacts the soft inner bone to create a cavity inside the vertebrae.
  3. The balloon is removed and the doctor uses specially designed instruments under low pressure to fill the cavity with a cement-like material called polymethylmethacrylate (PMMA). After being injected, the pasty material hardens quickly, stabilizing the bone.

The kyphoplasty procedure takes about one hour for each vertebra involved. Kyphoplasty is a safe and latest minimally invasive treatment for the fragility spinal fractures. There is a instant relief of back pain and patient is mobilized the same day.

Besides the Kyphoplasty treatment for fragility vertebral  compression fractures, injection teriparatide, along with calcium and vit D,  should be started for 2 years,  to increase the bone mass and avoid further fractures.

Other latest techniques have also evolved in kyphoplasty like vessel pasty and spine jack, where collapsed fractured  bone is reduced & elevated,  more effectively by jacking it up and using bone cement with the titanium jack in place.

The only serious complication of kyphoplasty is cement leak into the spinal canal causing paralysis. But is very rare and prevented by using correct technique and cement in its dough phase (not liquid state).