Kyphoplasty: How to Prepare

Kyphoplasty (also known as “vertebral augmentation”) is a minimally-invasive surgical procedure that treats spine compression fracture associated with osteoporosis, tumor growth, or injury. Depending on the case, kyphoplasty can be performed while the patient is put to sleep or while awake and under local anesthetic.

It’s typically an outpatient surgery. Most are able to go home the same day. An engaged and informed patient is essential to the success of the procedure. If you’re considering kyphoplasty or are scheduled to undergo it, you’ll need to understand what goes into preparing for this surgery.

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Kyphoplasty is not an open surgery and relies on minimally-invasive techniques. The surgeon uses a specialized balloon to create a space in the broken bone and then fills it with bone cement to reinforce and repair the structure

This being the case, it’s performed in either a surgery ward or an outpatient center of a hospital or clinic. What’s the set-up look like for this procedure? Though there may be some variations, expect to find:

  • Operating table: When the medical team is ready, you’ll be asked to lie face down on an operating table. If you’re doing local anesthesia (in which you remain awake during the procedure), the numbing medicine will be topically applied, and you’ll be hooked to machine that delivers drugs to put you to sleep in general anesthesia cases.
  • X-ray machine: Imaging is employed throughout the procedure to help guide the surgeon’s work. Typically, an approach called fluoroscopy is employed; this involves injecting a radioactive dye into the patient and performing X-ray scanning to help sharpen video images transmitted to a monitor.
  • Trocar: This is a specialized syringe that is guided by imaging to the problem area. The surgical balloon is positioned and inflated using this device, and when ready, it delivers the bone cement, and then is used to remove the balloon.
  • Bone cement: Though there are a few different materials used, most commonly a substance called polymethylmethacrylate (PMMA) is used. Before this or an alternative hardens in the body, it looks like toothpaste.
  • Heart monitor: Especially if you’re having the procedure done using general anesthesia, doctors often need to monitor heart rate and blood pressure. This lets them know if anything is going wrong during the procedure.
  • Oxygen monitor: Keeping track of your oxygen levels and lung activity can be especially important when general anesthesia is employed.
  • Intravenous (IV) drip: You’ll likely be attached to a tube that delivers general anesthetic during surgery.
  • Ultrasound machine: This is another method of imaging that may be used. Ultrasound works by beaming and then receiving high-frequency sound waves to create usable depictions of the affected area.

What to Wear

In a majority of cases, you’ll be allowed to recover at home, so typically you won’t need to prepare for a hospital stay (that said, this is necessary in some cases). As you’ll be advised, however, you do have to think about what you can and cannot wear on surgery day. Here are some quick tips:

  • Wear looser clothes that are primarily comfortable to wear. While stitches aren’t usually necessary for kyphoplasty, you still don’t want to show up in tight-fitting clothes.
  • Remove nail polish or acrylic if you use these.
  • Skip the jewelry as earrings, rings, necklaces, or other pieces might it affect imaging or hinder the surgery’s progress.
  • Stay scent-free and do not use any perfumes or fragrances on the day of the procedure.

Food and Drink

Since kyphoplasty is not an open surgery, there are usually not as many dietary restrictions required to prepare for it. As your doctor will tell you, however, certain precautions do need to be taken in the last six hours before the procedure. Typically, here’s what you can expect:

  • Don’t eat any kind of food
  • Avoid most drinks, including juices, coffee, cream, and milk
  • You can sip water or clear liquids when taking medications


In a consultation before kyphoplasty, you and medical staff will have to go over what prescribed, over-the-counter, or herbal medications you’re taking. Generally speaking, you’ll be able to take any prescribed drugs as usual; however, some doctors may ask you to modify the dosage of or stop taking blood-thinning medications, such as:

It’s absolutely essential that you let your doctor know exactly what you’re taking. Come to your consultation prepared with a list of all prescriptions, over-the-counter drugs, as well as herbal supplements you’re taking.

In addition, as you prepare for kyphoplasty, you may be advised to take daily high-dose calcium supplements and be prescribed bone-strengthening, anti-osteoporosis medications, including:

  • Actonel (risedronate)
  • Boniva (ibandronate)
  • Fosamax (alendronate)
  • Reclase (zoledronic acid)

While doctors usually won’t prescribe any special medications to prepare for surgery, on the day of surgery you may be given some drugs to aid with the procedure. To help prevent infection, you may have to take (or be administered) antibiotics, and, alongside the anesthesia, some require drugs to help manage nausea. 

What to Bring

While staying overnight at the hospital isn’t usually required for kyphoplasty, you’ll still need to make sure you have everything you need. What should you have along? What arrangements need to be made? There are a few:

  • A driver: You’ll likely feel woozy after surgery and be on medications to manage pain, so you must have someone with you to drive home. If a loved one or friend is unable to do it, talk to the clinic or hospital staff to arrange for transportation.
  • Insurance information: In most cases, the clinic or hospital will already have this on file; however, it never hurts to have your insurance card on hand.
  • Toiletries: Especially if an overnight stay is expected, it’s a good idea to have toiletry basics along. There are some cases where doctors will want to keep observing for a day after surgery.
  • Medications you’re taking: As noted above, it’s important to talk to your doctor about what you’re taking. Unless otherwise counseled, bring a list of what you’re taking, as well as any prescription drugs along.

Pre-Op Lifestyle Changes

Kyphoplasty is rarely the first treatment of spine compression fracture, so you’ll likely already be undergoing some form of therapy in the time preparing for the procedure. In particular, physical therapy is typically indicated before and after your surgery as part of a broader regimen to manage existing pain and prevent it from getting worse.

Here’s what may be emphasized in this work:

  • Safe aerobic exercise: Good physical fitness will always improve surgery outcomes and can help reduce recovery time. You’ll be counseled on safe, gentle, but effective activities you can do to exercise your body in preparation. Aquatic exercises and walks are particularly popular.
  • Avoid dangerous activities: As you try to boost your health, make sure you aren’t putting your back in danger. Don’t do exercise that strains it, such as crunches or sit-ups.
  • Stretching: Physical therapists can also recommend stretches that you can do to help with pain. Incorporating a regular routine based on their guidance can also help reduce post-operative recovery time.
  • Weight-bearing exercise: With the guidance of your physical therapist—and depending on your pain level—you may also have to do some weight-bearing exercises geared at strengthening the back.

A Word From Verywell

Back pain problems, such as those associated with spine compression, can be very challenging to manage, and kyphoplasty is just one of many approaches employed. As performed today, this procedure can be very effective in managing pain symptoms and restoring stability in the spine.

Despite some risks, it’s also very safe; according to the American Academy of Neurological Surgeons, kyphoplasty for osteoporosis has only a 3% complication rate.

For as effective and safe as it is—for as well-tolerated it is—it’s not unusual to feel anxiety or apprehension about it. Be sure to carefully weigh your decisions and learn as much as you can about your options. For many, this procedure has lead to less pain, improved mobility, and a better quality-of-life.      

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Article Sources
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  4. Physiopedia. Kyphoplasty. 2020. 

  5. Radiological Society of North America, American College of Radiology. Vertebroplasty and kyphoplasty. 2019. 

  6. American Academy of Neurological Surgeons. Vertebral compression fractures: symptoms, complications, diagnosis and treatments. 2020.