Spinecare Topics
Surgical Interventions
Kyphoplasty is a relatively new minimally invasive surgical procedure for treating fractures of the spine that occur secondary to thinning of the bone (osteoporosis). An accentuated mid-back curve is more common in postmenopausal women. Generally, osteoporotic fractures are characterized by compression of the front portion of the vertebral body causing it to become deformed into a wedge shape. This can result in pain, loss of height and an alteration of the curve of the spine leading to a hunched-over appearance. This hunched-over appearance is sometimes referred to dowager’s hump or widow’s hump.
Kyphoplasty is a two-step process requiring insertion of a special balloon-like device into the compromised vertebrae in an attempt to stabilize the vertebrae and restore it to a more normal shape. The procedure involves inserting a balloon-like device into the vertebral body to expand the compressed vertebrae and inject a bone cement to provide stabilization. After successful placement into the bone, a cement-like material is injected into the vertebral body space created by the balloon in order to retain a correction provided by the balloon. Restoration of vertebral body volume, shape and configuration improves stability and alignment of the spine. Kyphoplasty is typically performed via a relatively small incision in the back.
Kyphoplasty is done in a hospital operating room setting under a local or general anesthetic. The entire procedure takes about an hour for each vertebral level. Some patients may return home the same day the surgery is performed. Kyphoplasty is a relatively new surgical technique and the long-term outcome is not known.
Vertebroplasty
Percutaneous vertebroplasty is also a relatively new minimally invasive procedure used to treat compression fractures when conservative therapy fails to do so. The procedure is primarily used to seal and stabilize a fracture or collapsed vertebrae. It is performed to provide stability, and to reduce pain and related disability. The approach may be offered to the patient who has spine instability secondary to a fracture of the vertebral body. This type of fracture often occurs as a result of osteoporosis or as a result of destruction of portion of the vertebrae secondary to infection and/or a tumor. After confirmation of a vertebral compression fracture through CT or MRI, a vertebroplasty is performed with image guidance using the C-arm fluoroscope.
Vertebroplasty is a procedure that involves injecting a cement-like mixture into the vertebral body. The entire process takes anywhere from 1-3 hours, although the actual injection takes only a few minutes. The cement-like mixture hardens in about 20-30 minutes and provides stability to the vertebral body. Percutaneous vertebroplasty may be used in place of open surgery for osteoporotic patients. The approach will not correct the amount of bone loss due to the osteoporosis, but it does help stabilize new fractures.
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