Vertebroplasty (Kyphoplasty) for Compression Fractures of the Spine
Osteoporosis is an important problem for 44 million Americans and causes over 750,000 vertebral compression fractures (VCF's) in the spine annually. Trauma can also cause VCF. These fractures result in both acute and chronic back pain, but are also associated with patient immobility and its associated morbidity (deep venous thrombosis), impaired respiratory function with advanced disease, and narcotic medication dependence.
Percutaneous vertebral augmentation with vertebroplasty or kyphoplasty offers a minimally invasive approach for the treatment of VCF. Under local or general anesthesia, a needle is inserted to the vertebral body and cement is inserted, with or without balloon inflation. The mechanism by which the cement injection improves the patients' pain is likely by a thermal reaction that heats nerve endings at the site of the fracture. An alternative mechanism is that when two fracture planes are in contact with each other, any movement can elicit significant pain. Cementing these two planes may prevent this constant friction.
There is up to 80% chance that this intervention can improve pain and quality of life for selected patients with vertebral compression fracture. Remarkably, some patients who were bedbound, or functionally limited by pain are able to walk comfortably after the procedure. The procedure can be done as outpatient or inpatient.
Our kyphoplasty/vertebroplasty experience includes over 250 procedures performed to date treating osteoporotic and traumatic compression fractures, metastatic compression fractures and multilevel compression fractures in myeloma patients.
If we can answer questions on this subject, please feel free to contact either of us at 617.638.6595.
BMC Neurointerventional Service
Alexander Norbash, MD
Thanh Nguyen, MD