Balloon Kyphoplasty & Vertebroplasty
As we get older our bones become weaker, more brittle, and can easily break even without a fall. These so called insufficiency compression fractures are very common and can cause severe back pain and an increasing tendency to stoop. The balloon kyphoplasty procedure is a minimally invasive surgical procedure performed in a hospital to treat vertebral compression fractures. Balloon kyphoplasty is used to treat a broken bone in the spine, specifically when a vertebra is fractured. It involves inserting a balloon into the broken bone (fractured vertebra), inflating it to create a cavity and restore height lost, then removing the balloon and filling the cavity with bone cement to stabilize the vertebra
Both procedures (cement augmentation) involve injecting cement into the broken vertebra and are recommended by NICE (National Institute for Health and Care Excellence). A doctor will recommend and perform the procedure, providing essential medical oversight throughout the process. Vertebral compression fractures (VCF) occur commonly in elderly and post menopausal women due to osteoporosis, often resulting in vertebral fracture, height lost, and vertebral deformity. The procedure is performed in a hospital setting, with the patient required to lie face down on the operating table, and live x ray imaging is used to guide the insertion of the needle and balloon into the vertebrae. During the procedure, the balloon is inserted and inflated to restore the height of the vertebra, then removed, and the cavity is filled with bone cement, which is injected to stabilize the bone. As with any surgical procedure or surgery, there are potential risks and complications, including rare but serious risks to the spinal cord. Patients are advised to avoid strenuous activity after the procedure as part of the recovery process.
http://guidance.nice.org.uk/TA279
Several of our specialists at The UK Spine Centre have extensive experience in this technique. In addition Mr Aylott trains surgeons on this technique and has presented cases and evidence at International meetings.
Introduction to Spinal Injuries
Spinal injuries can dramatically affect a person’s daily life, especially when they involve vertebral compression fractures. A vertebral compression fracture occurs when one of the bones in the spine, known as a vertebra, collapses under pressure. This collapse often results in a loss of height in the vertebra, causing severe pain, reduced mobility, and sometimes a visible spinal deformity. Compression fractures are most commonly seen in older adults, particularly those with osteoporosis—a condition that weakens the bones and makes them more susceptible to breaking even with minimal trauma. However, these injuries can also result from accidents or other medical conditions that compromise bone strength.
The symptoms of a vertebral compression fracture can range from mild discomfort to intense, persistent pain that interferes with normal daily activities. In some cases, the fracture may lead to a stooped posture or curvature of the spine, further impacting quality of life. Left untreated, these fractures can increase the risk of additional injuries and further deformity of the spine. Multiple vertebral fractures can cause the spine to become rounded and bent forward, leading to a hunchback appearance.
Treatment for spinal injuries, especially vertebral compression fractures, focuses on relieving pain, restoring spinal alignment, and preventing further fractures. Options may include pain medications, rest, physical therapy, and minimally invasive procedures such as balloon kyphoplasty or vertebroplasty. These treatments aim to stabilize the fractured vertebra, reduce pain, and help patients return to their normal activities as quickly and safely as possible.
Understanding the causes, symptoms, and available treatments for spinal injuries is essential for anyone at risk, particularly those with osteoporosis or a history of trauma. Early diagnosis and appropriate intervention can make a significant difference in maintaining mobility, independence, and overall quality of life.
Understanding the Condition
Vertebral compression fractures are a common and often painful condition, especially in older adults and those with osteoporosis. These fractures occur when one of the bones in the spine, known as a vertebra, collapses and loses height, often forming a wedge shape. This collapse can lead to severe pain, reduced mobility, and an increased risk of spinal deformity or further fractures. Osteoporosis, a condition that weakens the bone structure, is the leading cause of these fractures, making the bones more susceptible to breaking even with minimal trauma.
The primary aim of treatments like balloon kyphoplasty is to relieve pain, restore the normal height of the vertebral body, and stabilize the fracture to prevent additional injury. Balloon kyphoplasty is a minimally invasive procedure that uses a small incision and a hollow needle to access the fractured vertebra. Under local anaesthetic, an orthopaedic surgeon carefully inserts one or two balloons into the collapsed vertebra and inflates them to create a cavity and restore the bone’s height. Once the balloon is removed, bone cement is injected into the space, filling the cavity and stabilizing the vertebra as the cement hardens. This technique not only helps to relieve pain but also reduces the risk of further fractures and spinal deformity.
Patients suffering from vertebral compression fractures often rely on pain medications to manage their discomfort, but when pain is severe or persistent, surgical procedures like balloon kyphoplasty may be recommended. The procedure is performed with precision to minimize risks such as infection, nerve injury, or leaking cement. Most patients experience significant pain relief and improved mobility soon after the procedure, allowing them to return to normal daily activities more quickly. Studies have shown that balloon kyphoplasty improves mobility and quality of life for patients with vertebral fractures.
Recovery from balloon kyphoplasty is typically straightforward. Patients are encouraged to rest, avoid heavy lifting, and use an ice pack to reduce any discomfort in the surrounding area. It is important to follow the doctor’s advice regarding strenuous activities and to attend follow-up appointments to monitor healing and bone health. The National Institute for Health and Care Excellence (NICE) has approved balloon kyphoplasty as an effective treatment for vertebral compression fractures, highlighting its safety and benefits for patients. You will likely be discharged on the same day of the procedure.
By understanding the condition and the available treatments, patients can make informed decisions about their care. With proper treatment and support, most patients experience lasting pain relief, improved posture, and a better quality of life.
Uses
This treatment is available for anyone with a painful unhealed vertebral fracture, performed anytime from a few weeks to months after a spinal fracture.
Vertebral fractures commonly occur in elderly patients and post menopausal women due to osteoporosis. VCF occurs when the vertebrae lose height as a result of compression, leading to pain and spinal deformity. The procedure helps restore height lost due to vertebral compression fractures, improving spinal structure and reducing further complications.
Cement augmentation is a very well tolerated procedure and we regularly perform this on older patients, quickly improving pain, posture, mobility, and overall quality of life.
Procedure
The balloon kyphoplasty procedure is a minimally invasive surgical procedure performed under local anaesthetic with sedation, avoiding the need for general anaesthesia. This makes the surgical procedure suitable for medically frail or elderly individuals. During the procedure, the patient will lie face down on the operating table. All patients go home the same day.
Live X-ray imaging is used to guide the insert of small needles through the back into the broken vertebra. In kyphoplasty, a balloon is inserted into the collapsed vertebra and then inflated to create a cavity. Once the balloon is deflated and removed, the cavity is filled with bone cement that is inserted to stabilize the fracture. In vertebroplasty, the surgeon will inject bone cement directly into the vertebra without using balloons. The procedure takes about 15 minutes to perform.
We generally prefer kyphoplasty to vertebroplasty because the powerful balloons enable restoration of the vertebra height. This reduces the spinal deformity which benefits patients in standing taller and straighter afterwards.
Success
In our experience at The UK Spine Centre this is a simple, low risk and very effective treatment.
The procedure also helps restore vertebral height lost due to compression fractures, improving spinal alignment and posture.
Most patients notice that their fracture pain is almost immediately better and they can walk, stand, and bend more comfortably.
Risks
Like any surgery, balloon kyphoplasty carries potential risks and complications, although the chance of having a complication is very low and the procedure is well tolerated even in elderly or frail individuals. It is important to understand these potential risks before proceeding.
In our centre we have the experience of performing this under local anaesthetic which reduces any general anaesthetic risks.
There is less than a 1% chance of having a complication; these complications can include cement leakage, infection, nerve injury, spinal fluid leak, ongoing or worse symptoms, bleeding, blood clot, or other medical complication. Rarely, cement leakage or nerve injury can affect the spinal cord, potentially leading to serious neurological issues such as paralysis. A small amount of cement can also squeeze out of the fracture during the procedure but this very rarely causes a problem.
It is worth remembering that we use this technique to fix the broken vertebra so the procedure does not stop you developing a similar fracture elsewhere.
Recovery
You will be up and about immediately following the procedure and home within a few hours.
You will have a few small dressings on the back but no stitches are required.
Most patients report that their back immediately feels stronger and more comfortable, and they can stand taller and straighter.
Usually any painkillers you were taking before your operation can be reduced or stopped.
The following day you can return to walking and exercise, which you can build up progressively. However, you should avoid strenuous activity, such as heavy lifting or intense physical exertion, during the recovery period as advised by your specialist.
We will probably recommend a bone density scan from your GP, if this has not already been done. This is to determine the strength of your bones and consider the need for further medical treatment to reduce the chance of further fractures.
We will see you back in the clinic 6 weeks following the procedure. Our team will support you before and after the procedure and your specialist remains available to you at any time.
Further Reading
Please see our Patient Stories which describe real patients, their problems, diagnosis and successful treatment under our care at The UK Spine Centre.
We also invite you to read our published articles on Balloon Kyphoplasty which you will find under the articles section on this website.
Osteoporotic Vertebral Compression Fractures (VCF)
As we get older our bones become weaker, more brittle, and can easily break even without a fall…
As we get older our bones become weaker, more brittle, and can easily break even without a fall…
Fractured Spine Recovery in Elderly UK: Causes, Prevention and Treatments
As we get older our bones become weaker, more brittle, and can easily break even without a fall…
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