Balloon kyphoplasty for painful spine compression fractures

Overview

A compression fracture happens when a bone in the spine (a vertebra) cracks and partly collapses. It is often caused by osteoporosis, a condition that makes bones weak. Sometimes it happens after a small fall, a hard cough or lifting something. The pain is usually sudden and is often worse when you stand or move. Many fractures heal with time, a brace and pain medicine. If the pain stays severe, balloon kyphoplasty may help. In this procedure, a small balloon makes space inside the broken bone, and the space is filled with bone cement to help steady it.

Watch: how Kyphoplasty & Vertebroplasty works

Video: “Vertebral Compression Fracture Treatment: Vertebroplasty and Kyphoplasty Explained” from DePuy Synthes on YouTube. It loads from youtube-nocookie.com only when you press play. Shown for general education; GSMC did not produce it. Watch on YouTube

What it is

Balloon kyphoplasty is a minimally invasive procedure for painful vertebral compression fractures. Through a small opening, a hollow needle is placed into the broken bone. A small balloon is inflated to create a space, then removed. The space is filled with bone cement, which hardens quickly.

A similar procedure, vertebroplasty, puts cement into the bone without using a balloon first. Your physician will explain which may fit your fracture.

Who it's for

Kyphoplasty may help people who have:

• A painful vertebral compression fracture confirmed by imaging, often from osteoporosis
• Pain that makes it hard to walk, sit, sleep or do daily tasks
• Pain that has not improved enough with rest, a brace and medicines
• Some fractures caused by cancer that has weakened the bone

What the procedure involves, step by step

1. Before: an MRI or CT helps show whether the fracture is recent and suitable for treatment. We review your medicines, including blood thinners, and your bone health.
2. Anesthesia: the procedure is usually done as an outpatient with sedation or anesthesia.
3. Access: you lie on your stomach. Using live X-ray guidance, your physician places a hollow needle into the fractured bone through a small opening in the skin.
4. Balloon: a small balloon is inflated inside the bone to create a space, and then removed.
5. Cement: the space is filled with bone cement, which hardens within minutes.
6. Finish: the needle is removed and a small bandage is placed. Treating one level often takes under an hour.
7. Going home: after monitoring, most people go home the same day.

Recovery and what to expect

• Many people walk the same day.
• Soreness at the needle site for a few days is common.
• Some people notice less pain within days. For others it takes longer, and some people do not improve.
• You will slowly return to normal activities, as your physician advises.
• Bone health follow-up is important. One spine fracture raises the chance of another. We will talk about a bone density (DEXA) scan, calcium and vitamin D, osteoporosis medicines, exercise and fall prevention. We work with your primary care doctor or other specialists on your bone health plan.

Candidacy: who may or may not be a good fit

May be a good fit: people with a recent, painful compression fracture confirmed on imaging whose pain limits daily life despite initial conservative care.

May not be a good fit: people whose fracture has already healed or is not painful, people with an active infection, a bleeding disorder or blood thinners that cannot be safely paused, an allergy to the cement, or certain fractures where bone is pressing into the spinal canal. Some fractures need a different treatment or a surgeon's evaluation.

Risks in brief

Risks include cement leaking outside the bone, infection, bleeding and a short-term increase in pain. Rarely, leaked cement can press on a nerve or travel to the lungs. New fractures at other levels can happen, mainly because of osteoporosis. Research results are mixed for some groups of patients, and we will talk with you openly about whether the procedure makes sense for you.

Alternatives

Other options may include rest, a back brace, pain medicines, physical therapy, vertebroplasty or, for some fractures, spine surgery. Osteoporosis treatment is important no matter which option you choose.

Frequently asked questions

Insurance

GSMC participates with all Aetna plans, including Aetna HMO, and with many other insurance plans. Coverage for a specific procedure depends on your plan and may need prior authorization; call 732-202-3000 to verify. Our team can help check your benefits before treatment.

See accepted insurance

Related pages

Related conditions

• Vertebral compression fractures
• Osteoporosis
• Back pain

Related treatments and resources

• Back and neck braces
• Kyphoplasty printable handout