Purpose of Kyphoplasty

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Kyphoplasty (also known as “vertebral augmentation”) is a surgery to take on back pain related to damage and compression of vertebrae. It’s an approach considered in cases of fracture due to trauma or injury, or in progressive cases of osteoporosis, in which bones weaken and become brittle.

The procedure involves locating the damaged vertebrae and site of compression, and, using imaging and specialized tools, injecting a surgical balloon in the area. This is then filled up with specialized bone cement, reinforcing the bone, with the balloon being removed once everything is in place.

Though surgery like this is rarely the first-line of treatment in cases of progressive and chronic back pain, it’s highly effective in managing symptoms. If you’re considering this procedure, it’s important to understand as much as you can about why it’s done, who a good candidate is, as well as the other factors involved in making the decision to go ahead.

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Diagnosis Related to Kyphoplasty

Primarily, kyphoplasty is indicated in progressive and chronic back pain associated with vertical compression fracture, which is damage and compression of a vertebra.

As with most back surgeries, doctors will first attempt less-invasive measures, such as bed-rest, wearing a back brace, or pain medications. If these don’t manage symptoms, then surgery will be called for.

Primarily, vertical compression fractures arise due to three sets of diagnoses:  

  • Osteoporosis: A majority of these surgeries are done in cases of osteoporosis, a weakening of the bones leading to fractures and damage. This condition is more prevalent and can become especially difficult to manage among older people, post-menopausal women, tobacco users, and those with arthritis. 
  • Spinal fracture: Kyphoplasty may also be indicated in cases of fracture in the spine due to trauma or a fall. The resulting impact on the spine can cause compression and damage to vertebrae, leading to progressive and chronic pain problems.
  • Malignant tumor: Cancerous tumors that form in the spine can also lead to vertical compression fracture. Treatment often involves kyphoplasty to repair damaged vertebra, stabilize the area, and restore mobility.

Criteria

Beyond diagnosis, itself, several other factors are weighed to determine if kyphoplasty is an appropriate treatment. The criteria for the procedure include:

  • Severe pain: Chronic and severe pain is the primary indication for this procedure, and it can be especially instrumental in cases where other therapies are likely not to be effective. Notably, doctors will need to ensure that the pain is related to compression of the vertebrae and not caused by arthritis or other conditions.
  • Age over 70: Age impacts the bone’s ability to heal, so alternative and less-invasive treatments for fracture may not be promising. In these cases, this surgery may offer the best outcomes.
  • Limited mobility: This surgery will also be considered in cases where the back pain is significantly impacting range of motion, ability to walk, or function independently.

Tests and Labs

Proper diagnosis and evaluation are essential for the success of all surgeries, and kyphoplasty is no different. As such, a number of tests and assessments may be performed, including:

  • Physical exam: Alongside standard assessments like heart rate and blood pressure, the doctor will also evaluate and manipulate the painful area.
  • Blood work: A standard aspect of surgery preparation and diagnosis is assessment of the blood, which can tell the doctor a great deal about overall health as well as the presence of any other conditions.
  • Spine X-ray: Doctors will also need to carefully evaluate the vertical compression fracture and may use X-ray screening to do so. This approach may not be the best for people who are pregnant.
  • Magnetic resonance imaging (MRI): MRI relies on magnetic fields to produce real-time video imagery of the affected area.
  • Computerized tomography (CT): This is essentially a composite of X-ray images taken from multiple angles, essentially producing a three-dimensional representation of the affected area.
  • Radioisotope bone scan: This assessment of bone thickness and health relies on nuclear energy to detect abnormalities or other issues. A small amount of radioactive material is injected into the body and is tracked as it collects in the bones.

A Word From Verywell

While the prospect of back surgery will always be intimidating, it’s important to remember that kyphoplasty is a well-established and long-standing approach. Nowadays, technological and technical advances have made this procedure safer and more effective than ever before.

Beyond having the right medical team on your side, as well as the support of your loved ones, patient engagement and understanding will be critical in promoting good outcomes. Be open and responsive with your caregiver, let them know if anything seems off, and don’t be afraid to ask questions.

Back pain is challenging—even with surgery, managing it is an ongoing process—but there’s no denying that relief from this suffering will be worth the effort. 

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Article Sources
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  1. Chandra R, Maingard J, Asadi H et al. Vertebroplasty and kyphoplasty for osteoporotic vertebral fractures: what are the latest data?AJNR Am J Neuroradiol. 2017;39(5):798-806. doi:10.3174/ajnr.a5458

  2. Cleveland Clinic. Kyphoplasty / vertebroplasty: spine surgery. 2016. 

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