Vertebroplasty/Kyphoplasty
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What are Vertebroplasty and Kyphoplasty?
Vertebroplasty and kyphoplasty are minimally invasive surgical procedures used to treat vertebral compression fractures (VCF). VCFs refer to fractures that form in the vertebrae of your spinal column and are primarily caused by osteoporosis or bone cancer, both of which can cause a loss in bone density, mass, and strength. Friction between the broken pieces against one another, or when compression of the spinal cord could cause pain and significantly weaken the spine.
Key Differences Between Vertebroplasty and Kyphoplasty
Both vertebroplasty and kyphoplasty involve the insertion of surgical cement into the fractured bone to prevent it from collapsing, while relieving pain and other symptoms. A vertebroplasty directly injects surgical cement into the fractured area. Meanwhile, a kyphoplasty first inserts a balloon into the vertebral space and is then inflated before surgical cement is injected. The balloon helps expand the vertebra to create space for the surgical cement, which hardens to stabilise and strengthen the vertebra.
What Conditions Can Vertebroplasty and Kyphoplasty Treat
Both vertebroplasty and kyphoplasty may be recommended to treat various conditions, including:
- Vertebral compression fractures (VCF) caused by osteoporosis
- VCF due to a malignant tumour (resulting from bone cancer)
- Persistent pain that does not improve with conventional, nonsurgical treatment
- Serious complications caused by fractured vertebrae
- Impaired vertebral bone healing in older adults after a fracture
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Kyphoplasty may on rare occasions also be considered to treat VCF cases that may lead to kyphosis, a condition that causes an excessive forward curve of your spine.
How Vertebroplasty and Kyphoplasty are Performed
Before the procedure, you will first undergo a clinical evaluation to determine the presence and extent of VCFs in your spine. Imaging and blood tests are also ordered to assess your general health and identify potential risks before the procedure. Your spine surgeon will advise you on what to expect from the procedure, and you may need to stop taking certain medications before your surgery.
Vertebroplasty
Just before surgery, you will be sedated with either local or general anaesthesia to maintain your comfort during the procedure. Once sedated, the doctor will disinfect the surgical area before making small incisions in your back to reach the damaged vertebrae. They will then insert a trocar under x-ray guidance. They will then fill the trocar, with surgical cement. The trocar will be carefully inserted through the incision into the vertebral body to deliver the surgical cement to the damaged vertebrae. X-ray guidance is used to ensure the surgical cement is correctly injected and does not leak.
Once the cement is injected, it will typically harden within 20 minutes or so. Additional imaging may be performed to monitor the distribution of surgical cement in the surgical site. The trocar is then removed, and the doctor will stitch the incision or use a medical dressing to cover the surgical wound.
Kyphoplasty
Much like a vertebroplasty, the procedure begins with sedation using local or general anaesthesia, followed by disinfecting the surgical area. Then, the doctor will make small incisions in your back to reach the damaged vertebrae.
The doctor will prepare a balloon, which is then inserted through a needle and positioned within the surgical site. The balloon is slowly inflated to create a gap or cavity in the surgical area, which is then filled with surgical cement delivered via trocar injection. X-ray guidance will ensure the surgical cement is correctly injected to prevent leakage.
After the cavity is filled with cement, it will gradually harden over the next 20 minutes or so. The doctor will carefully monitor the distribution of surgical cement and its hardening before removing the trocar. The doctor will complete the procedure by closing the incision using stitches or medical dressing.
Vertebroplasty and Kyphoplasty Recovery
Vertebroplasty and kyphoplasty are commonly performed as outpatient treatments, as they are minimally invasive procedures. Your doctor will monitor your initial recovery after surgery, and in most cases, you can be discharged on the same day if there are no complications. You will need someone to drive you home, and you should minimise physical activity in the first few days or weeks.
Your doctor will suggest gradually increasing your activity at a comfortable pace. You should also avoid overexerting your spine with heavy lifting or other strenuous activities for at least six weeks. They may also schedule regular physiotherapy sessions to support your recovery and strengthen your spine with targeted exercises.
Frequently Asked Questions
Can vertebroplasty/kyphoplasty treat herniated discs?
Neither vertebroplasty nor kyphoplasty is a recommended treatment option for herniated discs. Your doctor will recommend more suitable treatments, including a discectomy.
Does vertebroplasty/kyphoplasty carry any risks?
Like most medical procedures, there may be a small risk of infection or allergic reaction. In rare cases, there may be a risk of a medical cement leak requiring immediate medical attention.
Will I need to wear a back brace after vertebroplasty/kyphoplasty?
Wearing a back brace may help support your spine during recovery after a vertebroplasty or kyphoplasty, preventing complications that could slow your healing. Your doctor will recommend a suitable duration of use, typically for a few weeks.
Our Orthopaedic Doctor and Surgeon for Vertebroplasty and Kyphoplasty
Dr. Razmi
FAMS (Ortho) | M Med (Gen Surg) (SG) | FRCSEd (Gen Surg) | MBBS (SG)
Dr. Razmi, a practicing orthopaedic and spine consultant at Mount Elizabeth Novena Hospital.
Dr Razmi routinely performs discectomy (minimally invasive surgery), decompression surgery, spinal fusion, motion preservation surgery including dynamic stabilization and dynamic fusion technologies and lumbar and cervical disc replacements. He is the first surgeon in Singapore to perform stand-alone anterior approached spine fusion using the Synfix implant.
Related Treatments
Treatments for lower back pain include physical therapy, lumbar epidural steroid injections, spinal fusion, disk replacement and more!
A slipped disc, also known as a herniated disc, happens when the soft inner core of a disc, called the nucleus pulposus, pushes through the tough outer layer, called the annulus fibrosus.
