Vertebroplasty
Vertebroplasty is a procedure performed by an interventional radiologist that involves injecting a special cement mixture into the small holes of weak or fractured vertebrae through a hollow needle. This weakened vertebrae is most commonly a result of a compression fracture. Once it dries, this cement mixture forms a support structure inside the vertebra and helps strengthen and stabilize it, making it less likely to fracture again. Also, restoring the original shape and height to the bone provides pain relief.
Kyphoplasty
Kyphoplasty is a procedure also performed by an interventional radiologist that involves a balloon is first inserted through the needle into the fractured vertebra to create a space to control where the cement mixture is injected. The insertion of this balloon may also help to restore some of original shape and height of the disc, providing pain relief. Once the balloon is removed, the cement mixture is injected into the cavity where the balloon was.
About Vertebroplasty and Kyphoplasty Surgery
For most neuro-spine vertebroplasty or kyphoplasty surgeries, patients are given a local spinal anesthesia. This is injected into the lower back into the space around the spinal cord and numbs the spine and lower limbs for the duration of your surgery. With spinal anesthesia, patients are also given medication to keep them sedated during the procedure. Occasionally, patients may receive general anesthesia and be put to sleep for their surgery. Talk with your neurosurgeon about the specific anesthesia you will receive.
Patients are placed on a special operating room bed that allows for optimal access to the spine and room for the surgeon to work and helps greatly reduce the potential for blood loss.
Your doctor will make a very small puncture in your back where the needle will be inserted. An X-ray is used in the operating room and this guidance allows your surgeon to insert the needle directly into the fractured vertebra. Some neurosurgeons may also use a special microscope during surgery to magnify the area they are operating upon.
If you are having a vertebroplasty, your surgeon will inject the cement mixture into the holes of your fractured vertebra as soon as the needle is in its proper place within the bone. During a kyphoplasty, a balloon is inserted into the needle first and then inflated once inside the bone. This restores it to its original height and creates a finite cavity for the cement to be injected into. The cement is then injected into the cavity created once the balloon is removed.
In both procedures, it takes about 20 minutes for the cement to harden and provide the support desired.
A CT Scan may be performed at the end of the procedure to check the proper placement of the cement. Once this is complete, the needle is removed and if necessary, the puncture wound is closed with skin glue or steri-strips (small pieces of tape).
These types of procedures can last anywhere from 30-90 minutes, depending on how many levels of the spine are fractured and to what extent. Your doctor can give you a more accurate assessment of surgical length.
Vertebroplasty and Kyphoplasty Hospital Recovery
Vertebroplasty or kyphoplasty recovery time in the hospital will depend on how many injured vertebrae you had repaired and your individual health history. Most patients go home the same day or one day after surgery, but your neurosurgeon will decide when you are ready for discharge.
If you require rehab before going home, a doctor from the Physical Medicine and Rehabilitation department will see you and make specific recommendations regarding your discharge.
In order to go home after a vertebroplasty or kyphoplasty, you need to be able to walk, eat, urinate and have a healing wound.
Vertebroplasty and Kyphoplasty Recovery at Home
Bed rest is recommended for the first 24 hours after surgery to ensure that the cement hardens properly, but you may get up to use the bathroom. Then, you should continue to gradually increase your activity and walking within and outside the home is encouraged.
- Avoid lifting and strenuous activity
- Do not lift objects greater than 10lbs until advised by your doctor
- Avoid lifting above the waist level and above your head for any prolonged period of time
- You are not allowed to drive a car
- Your doctor will give you specific instructions about driving on discharge or when you follow-up in the office
- You can ride as a passenger in a car as directed.
- Climbing stairs at home is permitted and tolerated with caution
- Sexual activity may resume when indicated by your doctor
- Remember to call and schedule your follow-up appointment with your doctor once you are at home
Wound Care
- You may shower, but avoid bathtubs, whirlpools and swimming pools until cleared with your doctor.
- If you have steri-strips (strips of tape), cover your incision as directed by your doctor. You or a companion may remove the tapes as directed.
- If your tapes do get wet, you may pat tapes dry or use hair dryer on cool setting.
DO NOT apply lotions or creams near incision site.
Contact your doctor immediately if you have:
- Swelling on or around the incision
- Incision becomes red and hot or has drainage
- Difficulty breathing or chest pain
- Swelling or tenderness in your legs or calves
- Fever of 100° or higher
- Difficulty controlling your bladder or bowels