Endoscopic Spine Surgery
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Kyphoplasty and Vertebroplasty
Kyphoplasty or vertebroplasty are procedures to treat vertebral body compression fractures. They can result in back pain and a kyphotic deformity and need treatment. Because vertebral body fractures result in the collapse or compression of a vertebra, they cause your spine to shorten and curve forward.
Such fractures can also be caused by osteoporosis, which makes bones thinner.
What is a Kyphoplasty
Kyphoplasty is a minimally invasive, FDA-approved, a procedure designed to treat pain and deformation of the spine resulting from vertebral compression fractures. The vertebrae are the main building blocks of the spinal column and can be susceptible to compression fractures due to trauma or a condition that weakens the bone (such as osteoporosis or cancer).
Often times this results in the acute onset of severe mid-back pain and kyphosis, sometimes referred to as a “hunchback” posture.
If a fracture is diagnosed within 6 months of its occurrence, repair of the fracture with kyphoplasty is indicated. Using only x-ray images and with tiny incisions, specialized needles are placed within the fracture, height is restored by inflating a balloon in the bone, and then the cavity is filled with cement.
Patients typically achieve immediate pain relief and prevention of further collapse of the spine into the kyphotic (hunchback) position. Severe kyphosis can result in difficulty breathing, compression of the abdominal organs, and accelerated degeneration of the spine.
What is a Vertebroplasty
Vertebroplasty is a procedure during which a special cement is injected into a fractured vertebra. This procedure targets relieving spinal pain and restoring mobility. Surely, vertebroplasty is not the first choice and usually, patients are offered conservative treatments. But if bed rest, some pain relievers or muscle relaxants don’t have a visible effect, a person might need vertebroplasty.
It is usually offered to those who have failed traditional methods of treating fractured vertebra or back pain. Also, patients who suffer from severe or prolonged pain or immobility or have complications after a fractured vertebra.
How to Prepare
Your doctor can give you the exact preparation plan. But typically it includes having some tests such as X-rays, MRI, and CT scans, collecting a complete medical history and performing a physical exam. These diagnostic procedures help determine the exact location and origin of pain.
At this stage, you need to tell your medical team about all the medications you use, as you might be advised to avoid some of them before the procedure. It is especially important in case you take blood-thinning medications.
During the procedure, you get sedation medication to relax or general anesthesia for severe pain.
Then, with X-ray guidance, your doctor inserts a needle through your skin and back muscles into the bone and injects cement into the vertebra. There may be several injections until the vertebra is completely full. After this, the needle is removed and the procedure is finished. As the incision is tiny, you don’t need stitches.
Usually, the procedure takes about an hour, but it can be longer if several vertebrae are treated.
After the procedure, a patient needs to lie on the back for about an hour so that the cement becomes hard. You are observed for a couple of hours and then your medical team can give you some pain relievers. Even though many patients experience almost immediate relief after the procedure, some need more time, so they use over-the-counter pain relievers. Your medical team can also assess your pain and make sure that there are no possible complications.
You might need to wear a back brace for some time and then come back for a follow-up appointment.
The procedures provide patients with a high success rate. About 75% of patients are active after the procedure and don’t report symptoms. In some cases, patients don’t even need physical therapy and rehabilitation. Both vertebroplasty and kyphoplasty can increase functional abilities and help return to the previous level of activity.
They also provide pain relief almost immediately or within a couple of days.
The procedures are quite safe and effective and do not need surgical incisions.
The potential risks of the procedure include excess bleeding and possible infection. Some people react badly to the medications used or the contrast dye and have an allergic reaction. In case of an unsuccessful procedure, nerves can be affected, resulting in a nerve injury. Nerve damage can result in tingling, numbness, and weakness. Among other risks are cement leaking out of position and increased back pain.