Pain Management Procedures
Kyphoplasty and Vertebroplasty
Kyphoplasty and Vertebroplasty
What are they?
Kyphoplasty and vertebroplasty are minimally invasive procedures used to stabilize selected painful vertebral compression fractures. Both place medical bone cement into the fractured vertebral body. Kyphoplasty first creates a cavity, usually with an inflatable balloon, before cement is placed. Vertebroplasty injects cement without the balloon step.
When may they be recommended?
They are most often considered for a recent, painful osteoporotic compression fracture that is confirmed on MRI or other advanced imaging and continues to cause substantial pain and loss of function despite appropriate nonsurgical care. They may also be used for selected fractures weakened by cancer. They are not routine treatment for an old, painless fracture or ordinary degenerative back pain.
What happens?
You lie face down. Sedation or anesthesia is provided, and continuous X-ray guidance directs one or two bone needles through the back into the fractured vertebra. In kyphoplasty, a balloon is inflated and removed. Cement is then placed slowly while the clinician watches for leakage. The treatment setting and anesthesia plan depend on medical needs.
Recovery and results
Many patients go home the same day or after short observation. Pain from the fracture may improve quickly, but soreness at the needle sites is expected. Activity is increased according to instructions. Treatment of the underlying osteoporosis remains essential because the procedure stabilizes one fracture but does not correct bone weakness.
Important risks and limitations
Risks include bleeding, infection, nerve or spinal cord injury, medication or anesthesia reaction, and cement leakage. Most leakage causes no symptoms, but cement can rarely compress a nerve or travel to the lungs. Not every compression fracture benefits, and evidence and coverage requirements depend on fracture age, imaging, pain severity, and prior treatment.
Preparing for your injection procedure…
Your instructions will depend on the procedure. Before any injection, tell the APG team if you:
Take aspirin, warfarin, clopidogrel, apixaban, rivaroxaban, or another medicine or supplement that affects bleeding. Never stop a prescribed blood thinner unless the clinician who manages it and the procedure team tell you how to do so safely.
Have diabetes, glaucoma, a bleeding disorder, an active infection, fever, or recent antibiotic treatment.
Could be pregnant, have an allergy to contrast dye or local anesthetic, or have reacted to steroid injections before.
Use an implanted pacemaker, defibrillator, spinal cord stimulator, or other electrical device.
Some procedures require fasting, a medication adjustment, or a responsible adult to drive you home, especially when sedation is planned. Follow the instructions provided for your specific appointment.
After your injection procedure…
Most injections are outpatient procedures. Mild soreness, bruising, temporary numbness, or a brief increase in the usual pain can occur. Follow the activity and bandage instructions you receive. Steroid medicine may take several days to have an effect and can temporarily raise blood sugar.
Call the office promptly for increasing redness, drainage, fever, severe or rapidly worsening pain, or new numbness or weakness. Seek emergency care for trouble breathing, chest pain, sudden loss of bladder or bowel control, a severe new headache, loss of vision, stroke-like symptoms, or rapidly progressing weakness.
This information is for general education and does not replace medical advice, diagnosis, or treatment. Not every procedure is appropriate for every patient, and results vary. Your APG care team will review your symptoms, examination, imaging, medical history, medications, and prior treatment before recommending a plan. Coverage requirements also vary by insurance plan.