Kyphoplasty is a minimally invasive procedure designed to stabilize and reduce pain from pathological vertebral compression fractures.
Kyphoplasty, developed in 1997, has evolved from the vertebroplasty technique, where acrylic bone cement, polymethylmethacrylate (PMMA) is injected percutaneously into the fractured vertebral body, stabilizing the vertebra as it sets. Kyphoplasty includes an additional step of inserting and inflating a bone tamp inside the vertebral body to restore vertebral height and create a cavity into which PMMA can then be injected.
Pathological vertebral compression fractures can be caused by osteoporosis, a malignancy in the underlying bone, or more rarely a benign blood vessel tumor in the vertebra known as a vertebral haemangioma. The traditional conservative treatment for pathological vertebral compression fractures, including bed rest and analgesics, has been unsatisfactory for many patients who are left with chronic pain, immobility and deformity. In the management of osteoporotic vertebral compression fractures, the use of open reduction and internal fixation has a limited place. The fixation of the osteoporotic spine is usually inadequate to correct the deformity occurring as a result of crush fractures. Open surgical techniques have also had little success.
Kyphoplasty, developed in 1997, has evolved from the vertebroplasty technique, where acrylic bone cement, polymethylmethacrylate (PMMA) is injected percutaneously into the fractured vertebral body, stabilizing the vertebra as it sets. Kyphoplasty includes an additional step of inserting and inflating a bone tamp inside the vertebral body to restore vertebral height and create a cavity into which PMMA can then be injected. Current research evidence (case series) shows that kyphoplasty appears efficacious, with studies showing that most patients gained significant pain relief and increased mobility.
Complication due to vertebroplasty includes spinal cord compression, radiculopathy, fractured ribs and pulmonary embolus (sometimes fatal). Complications resulting from kyphoplasty include nerve root or spinal cord compression, epidural hematoma, transient fever and hypoxia. Overall complication rates appear low, with complications due to kyphoplasty probably slightly less common than for vertebroplasty.