Kyphoplasty

Kyphoplasty - for compression fractures in the spine

A kyphoplasty is an outpatient procedure for treating painful compression fractures in the spine. In a compression fracture, all or part of a spine bone collapses. The procedure is also called balloon kyphoplasty.

This information will explain what it is, Dr. Singer can determine if it is for you.

What is a compression fracture? Compression fractures of the spine occur when the spinal bones, or vertebrae crack under pressure causing them to compress and collapse in height. Although this is most commonly seen in patient with osteoporosis, this can also occur as result of a high impact injury.

What is a kyphoplasty? Kyphoplasty is a procedure that is used to treat compression fractures. Not only does kyphoplasty help alleviate pain, but it also helps to restore the height of the fracture or compressed vertebrae. Most patients get near immediate relief of pain after this procedure.

Why would a patient need a kyphoplasty? Acute compression fractures of the spine can cause significant discomfort and can lead to permanent deformity of the spine. In these cases, kyphoplasty is used to treat these fractures in a minimally invasive way. This procedure is an excellent alternative to open spine procedures which have been used in the past. Kyphoplasty is performed through a small hole in the skin which decreases risks of postoperative complications. Kyphoplasty may be the appropriate treatment for compression fracture caused by osteoporosis, cancer, or an injury to the spine that causes broken bones.

Before the kyphoplasty procedure

Before surgery, always tell Dr. Singer or his staff:

• If you could be pregnant
• Which medicines you are taking, even those you bought without a prescription
• If you have been drinking a lot of alcohol
  
  During the days before the surgery:
• You may be asked to stop taking aspirin, ibuprofen, coumadin (Warfarin), and other medicines that make it hard for your blood to clot.
• Ask which medicines you should still take on the day of the surgery.
• If you smoke, try to stop.
  
  On the day of the surgery:
• You will be told not to drink or eat anything for several hours before the test.
• Take the medicines Dr. Singer told you to take with a small sip of water.
• You will be given an appointment with your arrival time. (Your procedure will start approximately an hour to an hour and a half after your scheduled appointment time - have your after-surgery transportation plan appropriately.)

What happens during a kyphoplasty? After changing into a hospital gown, you will be taken to the procedure room in a wheelchair. You will lay on your stomach on the procedure table during the procedure. An IV will be started and you will be hooked up to a cardiac monitor. You will receive sedative medications for your procedure, but you will not be under general anesthesia. You MUST have someone to drive you home after the procedure. There will be an incision made over the affected area of the back once the correct location has been confirmed via fluoroscopy. Access to the compression fracture will be obtained and then a small tube with an inflatable balloon will be inserted to the bone. The balloon is then inflated to help restore the height of the vertebral body. To finish the procedure, the balloon is then deflated, and a syringe is placed into the needle to transfer the cement into the affected vertebrae. Fluoroscopy is used to confirm placement. The cement is given time to harden, and all instruments are removed, and a sterile dressing is placed.

What are the risks of a kyphoplasty? Kyphoplasty is generally safe. Complications may include:

• Bleeding.
• Infection.
• Allergic reactions to medicines.
• Nerve injuries.
• Leakage of the bone cement into surrounding area (this can cause pain if it affects the spinal cord or nerves). Leakage can lead to other treatments (such as surgery) to remove the cement. In general, kyphoplasty has less risk for leakage of cement than vertebroplasty as the cement is placed within the balloon.

What happens after a kyphoplasty? You will be monitored until the sedation has worn off enough for you to safely go home. You will be free to get re-dressed and check out at the front desk. Take it easy for the rest of the day. You may feel sore for one to four days. You will follow up in the clinic in 2-4 weeks.

• Don't take a bath, swim, or sit in a hot tub for 7 to 10 days after your procedure. It is OK to take a shower or sponge bath during this time.
• You may put a clean bandage over the injection site(s) until they are healed.
• It's important to take care of your spine after your procedure. Follow these guidelines for 4 to 6 weeks after your procedure:
• Do not bend over or twist from your waist.
• Do not bend over deeply, such as to tie your shoelace.
• Do not lift any objects heavier than 5 pounds.

How long can I expect pain relief? People who have kyphoplasty often have less pain and a better quality of life after the surgery. They often need fewer pain medicines and can move better than before.

This information is for general education only. Specific questions or concerns should always be directed to your doctor. Your doctor can explain possible risks or side effects.