Vertebroplasty and kyphoplasty for compression fractures of the spine

Topic overview

Vertebroplasty and kyphoplasty are surgeries that relieve pain from compression fractures of the spine due to osteoporosis, tumors, or other conditions.1

Vertebroplasty

Vertebroplasty is used to relieve pain from spinal compression fractures. After giving a local anesthetic, the doctor inserts a needle into the person's vertebrae and injects a cementlike mixture into the crushed area. The needle is guided with an imaging technique called C-arm fluoroscopy. The entire process takes 1 to 2 hours, although the actual injection usually takes only about 10 minutes. The cement mixture hardens in about half an hour, and after a short recovery period the person is sent home. Painkillers are often given to the person for the first couple of days.

Kyphoplasty

Kyphoplasty can be used to restore the vertebrae to a more normal shape. The person is given either a local or general anesthetic, and then a small incision is made in the person's back. A balloon device is inserted into the fractured vertebrae and inflated. Subsequently, a cementlike material is injected into the space created by the balloon. The entire procedure takes 1 to 2 hours for each treated vertebra, and the person may return home that day or perhaps stay in the hospital overnight.

Few studies have been done on these surgeries. But two studies of vertebroplasty for painful compression fractures from osteoporosis compared people who got the cement to people who did not. In these two groups of people, there was not a noticeable difference in their pain or their ability to be active.2, 3

Because the surgeries are still relatively new, long-term results are not known. Serious complications are not common for these surgeries. But possible problems include allergic reactions, nerve damage, infection, and pulmonary embolism.4, 1 Complications are more common when more than one vertebra is treated at the same time.

Talk to your doctor about these surgeries compared to other treatments available for compression fractures.

References

Citations

  1. Nussbaum DA, et al. (2004). A review of complications associated with vertebroplasty and kyphoplasty as reported to the Food and Drug Administration medical device related Web site. Journal of Vascular and Interventional Radiology, 15(11): 1185–1192.
  2. Buchbinder R, et al. (2009). A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. New England Journal of Medicine, 361(6): 557–568.
  3. Kallmes DF, et al. (2009). A randomized trial of vertebroplasty for osteoporotic spinal fractures. New England Journal of Medicine, 361(6): 569–579.
  4. Rao RD, Singrakhia MD (2003). Current Concepts Review: Painful osteoporotic vertebral fracture. Journal of Bone and Joint Surgery, 85-A(10): 2010–2022.

Credits

Author Shannon Erstad, MBA/MPH
Editor Kathleen M. Ariss, MS
Associate Editor Pat Truman, MATC
Primary Medical Reviewer Anne C. Poinier, MD - Internal Medicine
Specialist Medical Reviewer Kirtly Jones, MD - Obstetrics and Gynecology
Last Updated November 21, 2008

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