Severe back pain can greatly interfere with everyday activities and work to the point where the normal quality of life is reduced or even lost completely. For those whose back pain is not treated with bed rest, braces, physical therapy, or pain medication, a minimally invasive surgery called Kyphoplasty (or Balloon Kyphoplasty) may be the solution.
What does Kyphoplasty Treat?
Kyphoplasty treats painful compression fractures in the spine.
Vertebral Compression Fractures
The line of vertebrae that compose the spine each have a thick portion of bone called the vertebral body that provides major support. The vertebral body can fracture or even collapse.
More than pain, these fractures can increase spinal bowing and decrease height. After one fracture occurs, the risk for more fractures is increased. This increased risk is because the distribution of weight is changed. In addition, with more fractures, the spine can angle forward resulting in kyphosis (stooped posture). Kyphosis has lead to reduced activity/mobility, decreased appetite, sleep disorders, impaired pulmonary function, and decreased quality of life in patients.
Common Causes of Vertebral Fractures
- Osteoporosis: Osteoporosis is the thinning bone that causes them to become brittle and fragile. Most vertebral compression fractures are a result of osteoporosis.
- Cancer/Tumors
- Trauma
The Procedure
Kyphoplasty can be performed in the hospital but is so minimally invasive that it is most often performed in an outpatient clinic, with either local anesthesia (the patient remains awake, but feels no pain) or general anesthesia (the patient is asleep). After either anesthesia is properly administered, the procedure proceeds as follows:
- The patient lies face down on a table and the health care provider numbs the area of the procedure.
- The doctor uses a real-time x-ray to ensure that he is guiding the needle/tube to the proper area of the spine after small incisions are made on each side of the spine.
- Balloon catheters are inserted and inflated to restore normal anatomy and biomechanics.
- The catheters are then removed and the spaces are filled with bone cement-like an internal cast.
Post Procedure
Patients are generally discharged within twenty-four hours after the procedure and can walk (no driving), but rest is recommended for at least the first twenty-four hours. Regular activities should be resumed slowly within the next few days, and heavy lifting should be avoided for six weeks. Patients should keep an eye out for bleeding or infection at the site of the procedure.
In most patients, there is significant immediate pain reduction. The compressed bone is stabilized and the proper vertebral height and alignment is restored. This leads to a better quality of life, including less need for pain medication, improved mental health, and emotional well-being, and vitality.
Procedural Risks
Most side effects are rare, but there is a possibility that the following will occur:
- Bleeding/infection
- Allergic reaction to medication or bone cement
- Leakage of bone cement
- New vertebral fractures: those with severe osteoporosis may have fractures at other levels (that can often again be treated with another kyphoplasty procedure)
- Nerve and spinal cord irritation: cement can irritate or damage the spinal cord or nerves, though it is rare. However, this irritation can result in pain, altered sensation, or in more severe cases paralysis.
Likely Candidates
Because vertebral compression fractures are most often due to osteoporosis, there are different groups that are more likely to need to undergo Kyphoplasty than others. Those groups are outlined in the following:
- Women are more susceptible to osteoporosis because they have less bone tissue than men and lose bone more rapidly because of menopausal changes.
- It is a greater threat to women of Caucasian and Asian descent, though African American and Hispanic women are at risk as well.
- Those over the age of fifty are more likely to have osteoporosis-related fractures.
- Small-boned and/or thin women.
- Those who have a family history of osteoporosis.
If you have significant chronic back pain that has led to deformity, talk to a doctor about treatment and to see if you are a candidate for Kyphoplasty. A number of tests may need to be completed, including MRIs and x-rays to determine whether or not the pain is due to vertebral compression fractions and if the best treatment is Kyphoplasty.
For more information, contact the Dallas Pain Relief Center.