Kyphoplasty and Vertebroplasty for Spinal Fractures

Question: Kyphoplasty vs. Vertebroplasty?

What is the difference between kyphoplasty and vertebroplasty with respect to the time limitations on the effectiveness of the treatments from the time of the bone fracture?

Doctor’s Response:
Different treatments depending on the age of the fracture

Some practitioners believe a kyphoplasty is better suited to treating bone fractures older than three months because a reduction with the balloon can be achieved.

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Besides reducing the spinal fracture with the balloon, the other principle difference between the two techniques is that the methymethacrylate (bone cement) is injected under high pressure with the vertebroplasty, whereas the kyphoplasty creates a cavity that the bone cement can be injected with little pressure. The higher the injection pressure, the more likely it is to extravasate into the canal or the venous system. Personally, as a spine surgeon, I would be very reluctant to perform a vertebroplasty in an older spinal fracture.

A better question is whether or not either procedure should be done for compression fractures older than six months. In these cases, I have obtained a bone scan with the thought that if there is increased bone turnover (the bone scan is “hot” at the fracture site), then stabilizing the fracture should help. If there is not increased activity at the site (the bone scan is “cold”), then the fracture would be assumed to be healed and no surgical intervention would be warranted.

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In Spine-health’s Doctor Advice section, physicians respond to frequently asked questions about back pain issues. These responses represent the opinion of one physician, and do not necessarily reflect the views of the broader medical community. The advice presented has not been peer reviewed by Spine-health’s medical advisory board.

Written by Medical Reviewer