The goals of kyphoplasty are to:
- Help restore some of the lost vertebral height.
- Stabilize the fractured vertebra.
- Eliminate the associated back pain.
Kyphoplasty is considered a minimally invasive surgery because it is performed through a small skin puncture rather than a larger (open) incision. A typical kyphoplasty procedure, described below, takes 1 to 2 hours per vertebral level to complete.
Preparing for Kyphoplasty
Before having kyphoplasty, it is typically recommended to quit or reduce unhealthy behaviors, such as alcohol or tobacco use. In particular, tobacco use may reduce the chance for bone healing after the procedure.
About a week or so before kyphoplasty, some medications may need to be temporarily halted until after the procedure, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or blood thinners. These medications could increase the risk for complications during the procedure, such as by negatively interacting with anesthesia or increasing bleeding. Final decisions about halting medications can vary depending on a patient’s individual needs and risks.
Most commonly, no food or drink is allowed 6 hours before having the kyphoplasty procedure. A small amount of water may be allowed up to 2 hours before surgery.
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Kyphoplasty Procedure Step-by-Step
A typical kyphoplasty follows these general steps:
- The patient lies face down on a padded table. Then the back is thoroughly cleaned where the needle will be placed. Local anesthesia and light sedation are applied, which typically allow the patient to remain awake throughout the procedure without feeling pain. The patient may not remember the procedure afterward.
- A small incision is made in the back through which a narrow tube is placed. Using fluoroscopy (x-ray guidance), the tube is carefully pushed along a path through the pedicle of the involved vertebra and into the fractured area.
- A special balloon (called a bone tamp) is then inserted through the tube and into the vertebra and gently inflated. As the balloon inflates, it compacts the soft inner bone to create a cavity inside the vertebra and return the vertebral body to a natural height.
- The balloon is removed. Then, using a specially designed instrument, the cavity is gradually filled with a cement-like material called polymethylmethacrylate (PMMA). After being injected, the pasty PMMA material quickly hardens, stabilizing the bone.
Immediately after kyphoplasty surgery, the patient is observed closely in a recovery room for an hour or two. If no complications develop during this time, the patient is typically allowed to go home. Driving is not advised so soon after surgery, so a ride home may need to be arranged beforehand.
Recovery from Kyphoplasty
Relief of the original back pain is immediate for some patients. In others, elimination or reduction of pain is reported within 2 days. At home, patients can return to their normal daily activities, but taking things easy the day after kyphoplasty is usually recommended. Strenuous exertion, such as heavy lifting, is typically avoided for at least 6 weeks.
Driving may be resumed with doctor’s permission a few days or a few weeks after kyphoplasty, depending on the patient’s medications and health status.
A follow-up appointment typically occurs a few weeks after the procedure to ensure that the recovery is going as planned.