What you need to know about:

Vertebroplasty and Kyphoplasty

Fast Fact

80%
Worth It Rating
Average Cost:
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Recovery Period:
Several days
Permanence:
Depends on patient condition
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Doctors
Time it takes:
30-90 minutes
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Anesthetize:
General Anesthesia

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Overview of

Vertebroplasty and Kyphoplasty

in Thailand

Vertebroplasty and kyphoplasty are minimally invasive procedures for the treatment of vertebral compression fractures (VCF), which are fractures of the vertebrae, the bones that make up the spinal column. These procedures involve the injection of a bone cement to immobilize bone fragments and reduce pain immediately. Kyphoplasty may help restore the spine to a more normal alignment and prevent severe kyphotic (“hunchback”) deformity to the spine. In someone who has had multiple fractures with previous wedging, kyphoplasty can prevent worsening of the deformity.

Goals of

Vertebroplasty and Kyphoplasty

Vertebroplasty and kyphoplasty are used to treat painful vertebral compression fractures in the spine, most often the result of osteoporosis.  Typically, vertebroplasty and kyphoplasty are recommended after less invasive treatments, such as bed rest, a back brace or pain medication, have been ineffective. Vertebroplasty and kyphoplasty can be performed immediately in patients with problematic pain requiring hospitalization or for conditions that limit bed rest and pain medications.  Vertebroplasty and kyphoplasty are also performed on patients who:  

-Are elderly or frail and will likely have impaired bone healing after a fracture

-Have vertebral compression due to a malignant tumor

-Suffer from osteoporosis due to long-term steroid treatment or a metabolic disorder  

Vertebroplasty and kyphoplasty should be completed within eight weeks of the acute fracture for the highest probability of successful treatment.

Price of

Vertebroplasty and Kyphoplasty

Average Cost

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Price Range

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Pros and cons of

Vertebroplasty and Kyphoplasty

Pros

-Vertebroplasty and kyphoplasty can increase a patient's functional abilities and allow return to the previous level of activity without any form of physical therapy or rehabilitation.  

-These procedures are usually successful at alleviating the pain caused by a vertebral compression fracture; many patients feel significant relief almost immediately or within a few days. Many patients become symptom-free.  

-Following vertebroplasty, about 75 percent of patients regain lost mobility and become more active, which helps combat osteoporosis. After the procedure, patients who had been immobile can get out of bed, and this can help reduce their risk of pneumonia. Increased activity builds more muscle strength, further encouraging mobility.  

-Vertebroplasty and kyphoplasty are usually safe and effective procedures.  

-No surgical incision is necessary—only a small nick in the skin that does not need stitches.

Cons

-Any procedure where the skin is penetrated carries a risk of infection. The chance of infection requiring antibiotic treatment appears to be less than one in 1,000.  

-A small amount of orthopedic cement can leak out of the vertebral body. This does not usually cause a serious problem, unless the leakage moves into a potentially dangerous location such as the spinal canal or the blood vessels of the lungs.  

-Other possible complications include infection, bleeding, increased back pain and neurological symptoms such as numbness or tingling. Paralysis is extremely rare.  

-Approximately 10 percent of patients may develop additional compression fractures after vertebroplasty or kyphoplasty. When this occurs, patients usually have relief from the procedure for a few days but develop recurrent pain soon thereafter.  

-There is a low risk of allergic reaction to the medications.

How it works:

Vertebroplasty and Kyphoplasty

Vertebroplasty and kyphoplasty are similar procedures. Both are performed using a hollow needle that is passed through the skin of your back into the fractured vertebra, using an x-ray machine to assist correct placement. In vertebroplasty bone cement called polymethylmethacrylate is injected through the needle into the fractured bone. In kyphoplasty a balloon is first inserted and inflated to expand the compressed vertebra to its normal height before the space is filled with bone cement. The procedures are repeated for each affected vertebra. The cement-strengthened vertebra allows patients to stand straight, reduces their pain, and prevents further fractures.

Preparation before

Vertebroplasty and Kyphoplasty

Pre - treatment

Tell your doctor about all the medications you take, including herbal supplements. List any allergies, especially to local anesthetic, general anesthesia or to contrast materials. Your doctor may tell you to stop taking aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) or blood thinners before your procedure. A clinical evaluation will be performed to confirm the presence of a compression fracture that may benefit from treatment with vertebroplasty or kyphoplasty. Other than medications, your doctor may tell you to not eat or drink anything for several hours before your procedure.

Recovery after

Vertebroplasty and Kyphoplasty

Post - treatment

After vertebroplasty and kyphoplasty you will be transferred to the recovery room for two hours. During this time you will be monitored and the degree to which your back pain has been alleviated will be assessed. Then you will be taken to your hospital room. During your hospital stay you will be encouraged to walk and move. Patients are generally discharged from the hospital within 24 hours.   Discomfort: After procedure pain and discomfort will be managed with narcotic medication. However, using these medications can cause constipation so you should drink more water than usual and eat foods high in fiber. If your pain is not severe you may take alternative pain medication, such as paracetamol.  Bathing / Incision care: Keep the incision covered and dry for 24 hours. After that period you may shower. Gently pat the incision site dry. Do not soak in a bathtub.

Risks & side effects

General complications of any surgery include bleeding, infection, blood clots, and reactions to anesthesia. The following are specific risks that should be considered. Cement leakage. Nerve damage New vertebral fractures. Residual pain.

FAQs:

Vertebroplasty and Kyphoplasty

Who is eligible for the procedure?

Vertebroplasty and kyphoplasty are generally reserved for people with painful progressive back pain secondary to osteoporotic or pathologic vertebral compression fractures. Candidates for these procedures often experience significant decreases in mobility and function as a result of the fractures.

When should kyphoplasty/vertebroplasty be considered?

These procedures may be used after less invasive treatments, such as bed rest, back bracing or pain medication, do not provide adequate relief or are causing side effects. These procedures can be performed immediately after the fracture occurs in patients with intolerable pain. Vertebroplasty and kyphoplasty should be completed within 2-3 months after fracture for the most effective treatment. The procedure should always be done before radiation therapy is begun.

How is a kyphoplasty different to that of a vertebroplasty?

In vertebroplasty:  -The physician advances a specialized needle into the fractured vertebrae under live X-ray guidance. -Once the needles are placed into the front part of the vertebrae, a specialized bone cement is injected into the vertebrae. -The cement then hardens. -The cement acts as an internal cast for the vertebrae, with the hopes of decreasing pain and preventing further vertebral collapse.  

In kyphoplasty:  -The physician advances a specialized needle into the fractured vertebrae under live X-ray guidance. -A small cavity is created inside the vertebral body by inflating a small balloon. -This space is filled with special cement. -The cement then hardens. -The cement acts as an internal cast for the vertebra, with the hopes of decreasing pain and preventing further vertebral collapse. -In some cases, kyphoplasty may also be able to restore some lost height in the vertebrae.

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