Vertebroplasty and Kyphoplasty

Vertebroplasty and Kyphoplasty

Overview: Vertebroplasty and Kyphoplasty are Minimally Invasive Spine Surgery Techniques used to treat select vertebral compression fractures caused due to trauma, osteoporosis, tumours, etc. In these, the vertebral body (spinal bone) which is collapsed due to fracture is augmented with injection of bone cement into it. This stabilizes the vertebra and reduces pain. In Kypholpasty it also corrects the kyphotic deformity due to collapse to a great extent.

A vertebral fracture unlike any other fracture causes pain. This acute pain usually resolves in 4-6 weeks’ time if caused due to minor trauma/ Osteoporosis. If the fracture does not heal, it may cause on going pain which affects quality of life. Similarly, these painful fractures are also caused by tumours. In such patients, these are extremely efficient techniques to provide pain relief. These techniques are a boon for treatment of such co-morbid patients.

Day care admission is recommended. The surgeon, after assessing the patient and x-rays/ CT/ MRI determines if a person is the right candidate for the surgery. For example, these surgeries are not done in unstable fractures or patients with neurological deficits. After a thorough discussion (understanding risks and benefits) with the surgeon, the decision for surgery is taken.

The procedure is usually done in general anaesthesia. It can also be done in local anaesthesia with sedation. The patient is placed prone (head down) on the operating table. A stab incision is taken over the fracture site after confirming it under C-arm (Intra operative X-ray). Under X-ray guidance, the needle is advanced through the pedicle into the fractured body. The bone cement is then injected. In Kypholasty, a balloon is inserted prior to administration of cement. The balloon expands and corrects kyphotic deformity to a certain extent. After confirmation of accurate and adequate injection of cement, the needle is withdrawn and dressing is done. In most patients, patient is shifted to the recovery room based on medical condition of the patient. Patient is made to walk 3-4 hours after the procedure. Once medically stabilized and walking independently, patient is planned for discharge on the same/ next day.

Specific Complications:

Some patients may develop allergic reactions to bone cement. During injection of cement, it may leak into nearby neuro- vascular structures and cause injury.

Disclaimer: The description of procedure is how usually a surgery is done. During the procedure, based on intra operative encounters which varies from patient to patient different steps may be performed.

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