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Every
year, 1.5 million fragility fractures occur in the U.S.
Vertebral compression fractures (VCFs) account for almost
half this number, making osteoporosis a major health concern.
Although fragility fractures can have a disastrous effect
on quality of life, in terms of treatment options, the
outlook for fracture treatment is bright.
Vertebral compression fractures (VCFs) have traditionally
been treated with bed rest, medication and bracing, all
of which help to decrease a patient’s pain but do
not address the spinal deformity. Surgery can address
the deformity but is typically reserved for cases of major
neurologic deficit and mechanical instability. Spinal
fractures can cause spinal deformity, back pain and loss
of height. Multiple VCFs often have serious medical consequences,
and managing these fractures exacts a toll on patients,
healthcare providers and society. This progressive deterioration
of health is referred to as "the downward spiral."
Since one fracture can bring on another, it is especially
important that VCFs be recognized and diagnosed early.
What is Kyphoplasty?
Vertebral compression fractures (VCFs) have traditionally
been treated with bed rest, medication and bracing, all
of which help to decrease a patient’s pain but do
not address the spinal deformity. Surgery can address
the deformity but is typically reserved for cases of major
neurologic deficit and mechanical instability.
Balloon Kyphoplasty is a minimally invasive option that
addresses both the deformity and the pain by stabilizing
the fracture and helping to correct the
vertebral body deformity. Physicians report significant
improvements at short- and long-term follow-up in patients
treated with Balloon Kyphoplasty, including:
• correction of vertebral body deformity
• significant reduction in pain
• improvement in quality of life
• improvement in ability to perform activities of
daily living
• low complication rate
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Balloon
Kyphoplasty is an excellent option associated with a low
complication rate for patients suffering from painful
VCFs due to primary and secondary osteoporosis, cancer
and benign lesions. By achieving fracture stabilization
and correction of spinal deformity, patients experience
significant reduction in pain and improvement in mobility,
thus reducing the number of days in bed and increasing
overall quality of life. In the prospective multicenter
U.S. study, patients were asked to rate their level of
satisfaction with the outcome of their Balloon Kyphoplasty
procedure on a scale of 1-20, where 1 was “completely
dissatisfied” and 20 was “completely satisfied”.
The mean score at one week post-operatively was 17.5
(88%) and persisted throughout two-year follow-up.[1]
The median score was 20 (100%), or “extremely
satisfied,” at all follow-up time points.
Balloon Kyphoplasty is a minimally invasive procedure
that can reduce back pain, as well as restore vertebral
body height and spinal alignment.
What do I need to do before the Procedure?
You will need to consult with your doctor to see if you
are a candidate for kyphoplasty. You will also need some
tests to identify which vertebrae are affected and whether
the procedure can be performed safely and with a high
degree of success. These tests include x-rays, an MRI
scan, and sometimes a CAT scan if MRI cannot be preformed.
If you are a candidate for the procedure, you will have
some blood tests done to avoid problems with bleeding.
The night before the procedure, starting at midnight,
do not eat or drink anything.
Take your usual medicines on the day of the procedure.
Call your doctor if you take insulin shots. Your doctor
may change the insulin dose for the day of the procedure.
Do not take any pain medicine for at least 4 hours before
the procedure. You will be sedated during the procedure.
Prepare to spend one night in the hospital.
What happens during the procedure?
The Kyphoplasty is performed in the interventional suite
in the Radiology department by trained interventional
radiologists and technologists. During the procedure,
you will lie face down on a table that can be moved in
all directions. Above the table is a fluoroscope that
uses x-rays so that the radiologist can "see"
what he is doing. The radiologist will give medication
that will make you sleepy and relax you.
HOW IT WORKS
Step 1: Balloon insertion
Through a 1-cm incision, a working cannula is placed through
the pedicle, and an orthopaedic balloon is guided into
the fractured vertebral body.
Step 2: Full inflation
The balloon is inflated, reducing the fracture and elevating
the superior endplate. In an attempt to achieve an “en
massee” fracture reduction, the approach is bilateral,
using two balloons.
Step 3: Void within
vertebral body
Once the fracture has been reduced, the balloons are deflated
and removed. Inflation and deflation of the balloons creates
a void, which serves as a repository for the bone cement.
The void is then filled with Bone Cement under low, manual
pressure.
Step 4: Cement fill
The procedure typically takes less than one hour per fracture
treated and may require a brief hospital stay. After the
procedure, the patient should return to the osteoporosis-treating
physician for medical management and follow-up.
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What can I expect after the procedure?
Once you get to your room you will stay in bed for 2 hours
to let the bone cement fully harden During this time you
can ask for pain medication if needed. Usually, you will
go home the next day and receive a prescription for pain
medication. Remember that this is a surgical like procedure
and you will likely have some wound pain that will subside
in four to seven days. The wounds should be kept clean
and dry for at least three days. You will receive written
instructions to follow at home.
What are the Risks?
Any invasive procedure may have complications. The radiologist
will discuss possible complications with you before the
procedure.
One possible complication is allergy to the medicines.
Cement is injected into the vertebra during the procedure.
Rarely, the cement can leak outside the vertebra and press
on nerve roots or the spinal cord. In addition, it can
migrate to the lung. If these things happen, cement injection
is stopped immediately and usually there are no problems;
however, in a small percentage of cases these adverse
events can lead to worsened pain, paralysis, or require
surgery to remove the cement.
Any procedure that breaks the skin can result in bleeding
or infection.
Please feel free to download
this patient brochure to learn more.
You may also go to SpinalFracture.com
for more information.
If you have any questions about this procedure, please
discuss them with your nurse or physician. Feel free to
ask any questions.
Kyphoplasty is available at:
Piedmont Mountainside Hospital 706-301-5401
Cartersville Medical Center 770-606-2210 |
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