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Definition

Kyphoplasty is used to treat painful compression fractures in the spine. In a compression fracture, all or part of a spine bone collapses.

The procedure is also called balloon kyphoplasty.

Description

Kyphoplasty is done in a hospital or outpatient clinic.

• You may have local anesthesia (awake and unable to feel pain). You will likely also receive medicine to help you relax and feel sleepy.
• You may receive general anesthesia. You will be asleep and unable to feel pain.

You lie face down on a table. The surgeon cleans the area of your back and applies medicine to numb the area.

A needle is placed through the skin and into the spine bone. Real-time x-ray images are used to guide the surgeon to the correct area in your lower back.

A balloon is placed through the needle, into the bone, and then inflated. This restores the height of the vertebrae. Cement is then injected into the space to strengthen it and make sure it does not collapse again.

Why the Procedure Is Performed

A common cause of compression fractures of the spine is thinning of your bones, or osteoporosis. Your health care provider may recommend this procedure if you have severe and disabling pain for 2 months or more that does not get better with bed rest, pain medicines, and physical therapy.

Your provider may also recommend this procedure if you have a painful compression fracture of the spine due to:

• Cancer, including multiple myeloma
• Injury that caused broken bones in the spine

Risks

Kyphoplasty is generally safe. Complications may include:

• Bleeding.
• Infection.
• Allergic reactions to medicines.
• Breathing or heart problems if you have general anesthesia.
• Nerve injuries.
• Leakage of the bone cement into surrounding area (this can cause pain if it affects the spinal cord or nerves). Leakage can lead to other treatments (such as surgery) to remove the cement. In general, kyphoplasty has less risk for leakage of cement than vertebroplasty as the cement is placed within the balloon.

Before the Procedure

Before surgery, always tell your surgeon:

• If you could be pregnant
• Which medicines you are taking, even those you bought without a prescription
• If you have been drinking a lot of alcohol

During the days before the surgery:

• You may be asked to stop taking aspirin, ibuprofen, coumadin (Warfarin), and other medicines that make it hard for your blood to clot.
• Ask which medicines you should still take on the day of the surgery.
• If you smoke, try to stop.

On the day of the surgery:

• You will most often be told not to drink or eat anything for several hours before the test.
• Take the medicines your surgeon told you to take with a small sip of water.
• You will be told when to arrive.

After the Procedure

You will probably go home on the same day of the surgery. You should not drive, unless your surgeon says it is OK.

After the procedure:

• You should be able to walk. However, it is best to stay in bed for the first 24 hours, except to use the bathroom.
• After 24 hours, slowly return to your regular activities.
• Avoid heavy lifting and strenuous activities for at least 6 weeks.
• Apply ice to the wound area if you have pain where the needle was inserted.

Outlook (Prognosis)

People who have kyphoplasty often have less pain and a better quality of life after the surgery. They often need fewer pain medicines, and can move better than before.

References

Savage JW, Anderson PA. Osteoporotic spinal fractures. In: Browner BD, Jupiter JB, Krettek C, Anderson PA, eds. Skeletal Trauma: Basic Science, Management, and Reconstruction. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 35.

Weber TJ. Osteoporosis. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 225.

Williams KD. Fractures, dislocations, and fracture-dislocations of the spine. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 41.

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