What is thoracic kyphoplasty

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Abrupt onset of back pain. Intensification of pain instantly while standing or walking. A decline in pain intensity while lying on the back. Restricted spinal mobility. Eventual height loss. Eventual deformity and disability. Schedule an Appointment. What Is the Success Rate of Kyphoplasty? To minimize pain and discomfort, you will be given either general anesthesia, which puts you to sleep, or conscious sedation. Under conscious sedation you are awake, but feel no pain and may have no memory of the procedure.

Step 1: prepare the patient You will lie on the operative table and be given conscious sedation. Once sedated, you will be positioned on your stomach with your chest and sides supported by pillows. Depending on the section of the spine cervical, thoracic, or lumbar where the compressed vertebra is located, your back or neck will be cleansed and prepped. Step 2: insert the needle A local anesthetic is injected in the area where a small, half-inch skin incision will be made over the fractured bone.

With the aid of a fluoroscope a special X-ray , two large diameter needles are inserted into the vertebral body through the pedicles Fig 2. The fluoroscopy monitor allows the surgeon to see exactly where the needles are positioned and how far they are inserted.

The needles are advanced through the bone using either a twisting motion or a tapping mallet. The needles are angled to avoid the spinal cord. Depending on the vertebral level, a single needle may be used. Step 3: restore vertebra height kyphoplasty only If the vertebra is significantly wedge-shaped, the surgeon will insert inflatable balloons through the needles into the vertebra.

To insert the balloon tamps, the surgeon first uses a drill to create a working channel. The surgeon carefully inflates the balloons, raising the vertebra back to its normal height Fig.

The amount of height restored depends on the age of the fracture. The balloons are deflated and withdrawn, leaving a space in the middle of the vertebra.

This procedure is called kyphoplasty because it reduces unwanted kyphosis, or forward curvature, before the bone is stabilized. Step 4: inject bone cement Bone cement is slowly injected under pressure, filling the deepest area first, then withdrawing the needle slightly to fill top areas Fig 4. The pressure and amount of cement injected are closely monitored to avoid leakage into unwanted areas.

While complete filling of the vertebral body is ideal, it is not always possible or necessary for pain relief. Step 5: closure The needles are withdrawn promptly before the cement hardens. The small skin incision is closed with skin glue or steri-strips. You will not be moved from the operating table until the remaining cement in the mixing bowl hardens.

You will return to the recovery area. Your blood pressure, heart rate, and respiration will be monitored, and your pain will be addressed. You'll remain lying down for the first hour after the procedure. See Vertebral Fracture Symptoms. A kyphoplasty procedure uses x-ray guidance to place a needle through a small incision in the back and into the vertebral compression fracture. After the needle is accurately placed, a balloon is slowly inflated to help restore vertebral height and form a new cavity.

Bone cement is then injected into the new cavity and quickly hardens, which alleviates pain by strengthening and solidifying the damaged vertebra.

Most vertebral compression fractures heal on their own as the pain eventually goes away. In cases where a vertebral compression fracture has been verified via x-ray and significant pain persists for more than a couple weeks despite nonsurgical treatments, kyphoplasty may be considered if the following are true:. Other factors to consider before deciding on kyphoplasty also exist, such as whether the patient is healthy enough for surgery. For example, if the patient is of advanced age or has the compression fracture as a result of a bone infection, the surgery is unlikely to be well tolerated.

The surgeon with then fill the cavity with a cement like substance referred to as polymethylmethacrylate PMMA. Following injection, the patient will be closely monitored. This procedure may require a hour hospital stay. Patients undergoing kyphoplasty will not be permitted to drive following the procedure and must arrange transportation.

Relief from pain may be experienced almost immediately following kyphoplasty. However, patients may also require up to 48 hours before benefits are evident.