Vertebroplasty and kyphoplasty

• Vertebroplasty: bone cement is injected directly into the fractured vertebra under continuous imaging guidance to lock the broken bone fragments in place and eliminate painful micro-motion.
• Kyphoplasty (Balloon): Before injecting the bone cement, a high-pressure balloon is inserted into the collapsed vertebra and inflated. This creates a space within the bone while partially restoring lost vertebral height. The balloon is then deflated and removed, leaving a cavity that is filled with bone cement under lower pressure.

Vertebroplasty and kyphoplasty may be considered for patients with painful vertebral compression fractures, particularly when symptoms are significantly affecting mobility, independence, or quality of life.

These procedures are most commonly used in people with:

• Osteoporotic vertebral compression fractures: Fractures that occur when weakened bones collapse under normal everyday forces or following relatively minor trauma, such as a simple fall.
• Selected traumatic vertebral fractures: Some stable fractures caused by an injury may be suitable for treatment, depending on the type of fracture and the patient's symptoms.
• Pathological fractures: Fractures caused by conditions affecting the bone, such as metastatic cancer or multiple myeloma.

Not all vertebral fractures require intervention. Many can be managed successfully with pain management, activity modification, rehabilitation, and treatment of any underlying bone health condition. Your consultant will review your symptoms, scans, overall health, and treatment goals to determine whether vertebroplasty or kyphoplasty is appropriate for you.

Both procedures are performed percutaneously (through keyhole punctures in the skin) under local anaesthetic combined with sedation, or light general anaesthetic.

Pre-procedure planning

High-resolution X-rays and MRI or CT scans are reviewed beforehand to map the exact location, age, and extent of the vertebral collapse.

Step-by-step technique

1. Positioning and local numbing: You lie face down (prone) on a specialized operating table. The skin and deep tissue over the target spine level are thoroughly numbed with local anaesthetic.
2. Precision needle guidance: Using X-ray guidance, the surgeon advances a hollow needle (trocar) through the skin directly into the fractured vertebral body.
3. Cavity creation (Kyphoplasty only): A small inflatable balloon is guided through the needle into the bone and inflated under controlled pressure to restore vertebral height. Once the cavity is established, the balloon is deflated and withdrawn.
4. Cement injection: Special acrylic bone cement is carefully injected under live X-ray monitoring to ensure complete filling of the fracture without leakage. The cement hardens rapidly within 10 to 15 minutes.
5. Closure: The needle is removed, and a small sterile dressing is applied to the puncture site. No stitches are required.

Admission type and duration

• Vertebroplasty: Typically performed as a day-case procedure, taking 1 to 2 hours, allowing you to return home the same day.
• Kyphoplasty: Normally performed as an overnight stay, allowing for post-procedure monitoring and bed rest.

Local anaesthetic and sedation are used to keep you comfortable during the procedure. You may feel a sensation of pressure when the needle is positioned or, during kyphoplasty, when the balloon is inflated.

Some soreness around the injection site is common and usually settles with simple pain relief. While many patients notice an improvement in their fracture-related pain following treatment, the degree and timing of pain relief varies between individuals. Some patients experience early symptom improvement, whereas others may require several days or weeks to notice the full benefit of the procedure.

Your care team will discuss realistic expectations for recovery and provide advice on pain management, mobility and rehabilitation following treatment.

Vertebroplasty and kyphoplasty are routine, safe procedures. Complications are rare, particularly when performed under live image guidance, but potential risks include:

• Cement leakage: Small amounts of bone cement may leak outside the vertebral body into surrounding soft tissue or veins (usually asymptomatic).
• Nerve or spinal cord compression: Rarely, cement leaking into the spinal canal can cause localised nerve irritation or numbness (less than 1 in 1,000 cases).
• Adjacent segment fracture: Because the stabilized vertebra becomes very rigid, there is a slightly increased risk of a new fracture occurring in adjacent osteoporotic vertebrae.
• Localised infection or bleeding: Minor risk at the skin needle entry site.
• Allergic reaction: Minor reactions to contrast dye or local anaesthetics.

Your specialist will discuss all potential risks with you in detail during your consultation prior to the procedure.