Jun 27, 2023
Vertebroplasty vs. Kyphoplasty: Uses, Benefits, and More
Surgeries to treat spinal compression fractures Vertebroplasty and kyphoplasty are surgical procedures that involve injecting cement into a fractured vertebra in order to stabilize the broken bone and
Surgeries to treat spinal compression fractures
Vertebroplasty and kyphoplasty are surgical procedures that involve injecting cement into a fractured vertebra in order to stabilize the broken bone and relieve pain. Such fractures most commonly occur as a result of bone weakening from osteoporosis and can result in severe, persistent pain and disability.
While both are methods of vertebral augmentation with only a slight difference in how they are done, the procedures share common goals: To improve symptoms and quality of life.
Vertebroplasty and kyphoplasty are minimally invasive surgical procedures performed under sedation or general anesthesia in an outpatient facility.
Both vertebroplasty and kyphoplasty involve the injection of a type of cement called polymethylmethacrylate (PMMA) into fractured bone in the spinal column.
While the terms are often used interchangeably, kyphoplasty is really a subtype of vertebroplasty. It is distinguished by the fact that it involves an additional step of inserting and inflating a balloon before the cement injection. This creates a cavity that can lower the amount of pressure required to inject the cement.
Image guidance is used during vertebroplasty and kyphoplasty; this is accomplished with fluoroscopy or computed tomography (CT) scan. Image guidance helps guide the surgeon as they operate.
Kyphoplasty is generally performed more often than vertebroplasty and is associated with a lower complication rate. Nevertheless, research does not suggest that one procedure is more effective in terms of reducing pain and disability than the other.
These scheduled procedures are almost always performed on adults; rarely, they may be performed on a child. Most patients go home the same day after either procedure.
Absolute contraindications to vertebroplasty or kyphoplasty include:
Additional contraindications include back pain unrelated to a vertebral fracture, such as a disc herniation or spinal stenosis. Imaging tests, like a magnetic resonance imaging (MRI) of the spine, can help healthcare providers confirm a diagnosis.
Vertebroplasty and kyphoplasty are generally considered safe, low-risk procedures. However, in some instances, serious complications may occur.
These complications include:
Rare complications include:
The purpose of vertebroplasty and kyphoplasty is to alleviate pain and improve disability in patients with vertebral fractures. Kyphoplasty can also help restore some or all of the height of the bone and, therefore, improve spine alignment.
Most commonly, these procedures are used to treat compression fractures that result from osteoporosis. Less commonly, the procedures are used to treat fractures that result from cancer, trauma, or osteonecrosis.
While vertebroplasty and kyphoplasty are considered safe, they are not without risk. In addition, the data regarding the efficacy of these procedures is still evolving and conflicting.
As a result, vertebroplasty/kyphoplasty is generally only indicated in patients with a vertebral fracture who, despite undergoing conservative medical measures, continue to experience severe and disabling back pain.
Failed medical therapy may be defined as patients who:
If you have decided to undergo vertebroplasty or kyphoplasty, your healthcare provider will provide various pre-operative instructions.
These instructions may include:
With both vertebroplasty and kyphoplasty, bone cement is injected into the fractured vertebrae. Kyphoplasty also includes creating a cavity with a special balloon.
For vertebroplasty or kyphoplasty, you can expect the following steps to occur after you are prepared for surgery and anesthesia has been delivered:
After the procedure, which lasts less than an hour, you will be taken to a recovery room. Once the anesthesia or sedative has worn off, most patients are able to go home.
Before you leave the surgical center, your healthcare provider will provide you with various instructions to follow at home, such as:
Some patients experience immediate pain relief after vertebroplasty or kyphoplasty. For others, pain relief usually occurs within a few days of the procedure.
Vertebral fractures are common, especially in postmenopausal women, in whom osteoporosis is also common. Due to the potentially severe, disabling pain associated with these fractures, it's sensible to take steps to prevent another from occurring.
Prevention of osteoporosis-related vertebral fractures entails engaging in various non-pharmacologic therapies, including:
In cases where osteoporosis caused the fracture, initiating medication that treats the osteoporosis is indicated.
Even though scientific data comparing vertebroplasty/kyphoplasty to placebo has not demonstrated a robust clinical benefit, many medical professionals still utilize these procedures in treating severe and persistent pain related to acute osteoporotic vertebral fractures.
If you or a loved one are considering a vertebroplasty/kyphoplasty, do your due diligence and weigh the possible risks and benefits with your personal healthcare provider.
Cleveland Clinic. Kyphoplasty/Vertebroplasty. Reviewed December 2016.
Denaro V, Longo UG, Maffulli N, Denaro L. Vertebroplasty and kyphoplasty. Clin Cases Miner Bone Metab. 2009 May-Aug; 6(2): 125–130.
Goz V, Errico TJ, Weinreb JH, et al. Vertebroplasty and kyphoplasty: national outcomes and trends in utilization from 2005 through 2010. Spine J. 2015 May 1;15(5):959-65. doi:10.1016/j.spinee.2013.06.032
Evans AJ, Kip KE, Brinjikji W, et al. Randomized controlled trial of vertebroplasty versus kyphoplasty in the treatment of vertebral compression fractures. J Neurointerv Surg. 2016 Jul;8(7):756-63. doi:10.1136/neurintsurg-2015-011811
Singer G, Wegmann H, Kraus T, Gumpert R, Till H, Eberl R. Balloon kyphoplasty and percutaneous fixation of lumbar fractures in pediatric patients. Eur J Spine 25, 6–656 (2016). doi:10.1007/s00586-014-3686-z
Denaro V, Long UG, Maffulli N, Denaro L. Vertebroplasty and kyphoplasty Clin Cases Miner Bone Metab. 2009 May-Aug; 6(2): 125–130.
Papanastassiou I, Filis A, Gerochristou M, Vrionis F. Controversial issues in kyphoplasty and vertebroplasty in osteoporotic vertebral fractures. Biomed Res Int. 2014. doi:10.1155/2014/934206
Chandra RV, Maingard J, Asadi H, et al. Vertebroplasty and Kyphoplasty for Osteoporotic Vertebral Fractures: What Are the Latest Data? AJNR Am J Neuroradiol. 2018 May;39(5):798-806. doi:10.3174/ajnr.A5458
Elnoamany H. Percutaneous Vertebroplasty: A First Line Treatment in Traumatic Non-Osteoporotic Vertebral Compression Fractures. Asian Spine J. 2015 Apr; 9(2): 178–184. doi:10.4184/asj.2015.9.2.178
Laratta JL, Shillingford JN, Lombardi JM. Utilization of vertebroplasty and kyphoplasty procedures throughout the United States over a recent decade: an analysis of the Nationwide Inpatient Sample. J Spine Surg. 2017 Sep; 3(3): 364–370. doi:10.21037/jss.2017.08.02
Chandra RV, Meyers PM, Hirsch JA, et al. Vertebral augmentation: report of the Standards and Guidelines Committee of the Society of NeuroInterventional Surgery. J Neurointerv Surg 2014 Jan;6(1):7-15. doi:10.1136/neurintsurg-2013-011012
Johns Hopkins Medicine. Vertebroplasty. 2020.
American Academy of Orthopedic Surgeons. Osteoporosis and Spinal Fractures. Reviewed January 2016.
Johns Hopkins Medicine. Kyphoplasty. 2020.
Kling M J, Clarke BL, Sandhu NP. Osteoporosis Prevention, Screening, and Treatment: A Review. J Womens Health (Larchmt). 2014 Jul 1; 23(7): 563–572. doi:10.1089/jwh.2013.4611
Buchbinder R, Johnston RV, Rischin KJ et al. Percutaneous vertebroplasty for osteoporotic vertebral compression fracture. Cochrane Database Syst Rev. 2018 Apr 4;4(4):CD006349. doi:10.1002/14651858.CD006349.pub3
Bergmann M, Oberkircher L, Bliemel C, Frangen T, Ruchholtz S, Krüger A. Early clinical outcome and complications related to balloon kyphoplasty. Orthop Rev (Pavia). 2012 May 9;4(2):e25. doi:10.4081/or.2012.e25
Lou S, Shi X, Zhang X, Lyu H, Li Z, Wang Y. Percutaneous vertebroplasty versus non-operative treatment for osteoporotic vertebral compression fractures: a meta-analysis of randomized controlled trials. Osteoporos Int. 2019 Dec;30(12):2369-2380. doi:10.1007/s00198-019-05101-8
By Anne Asher, CPTAnne Asher, ACE-certified personal trainer, health coach, and orthopedic exercise specialist, is a back and neck pain expert.