Factors Your Doctor May Consider – Balloon Kyphoplasty

A spinal fracture (also called a vertebral compression fracture) occurs when one of the bones of the spinal column fractures or collapses. Osteoporosis causes loss of bone strength and stability and is the underlying disease in most patients suffering from spinal fractures.

In addition to osteoporosis, bone loss can occur as a side effect of medications such as corticosteroids, certain cancer treatments, and lifestyle choices including smoking, inactivity, and low calcium intake.

The bones in your spinal column are different than the bones elsewhere in your skeleton. For example, the bones in your legs are more rigid and dense than the bones in your spine. Strong, dense bone enables your legs to withstand rigorous movement. The bones in your spine, however, are less dense and more “spongy,” and thus more vulnerable to fracture.

Balloon kyphoplasty is a treatment option generally reserved for patients with back pain or deformity related to spinal fracture(s). After a physical exam, imaging tests such as x-rays or magnetic resonance imaging (MRI) might be ordered to confirm the diagnosis of a spinal fracture.

Patients are generally seen by a GP before referral to a specialist. After treatment with balloon kyphoplasty, the patient is then referred back to the GP for medical management of the underlying disorder.

Most patients report relief from pain and improved mobility after the procedure.¹

As with most surgical procedures serious adverse events, some of which can be fatal, can occur. These include heart attack, cardiac arrest (heart stops beating), stroke, and embolism (blood, fat or cement that migrates to the lungs or heart). Other risks include and are limited to infection; leakage of bone cement into the muscle and tissue surrounding the spinal cord and nerve injury that can, in rare instances, cause paralysis; leakage of bone cement into the blood vessels resulting in damage to the blood vessels, lungs and/or heart.

This procedure is not for everyone. Please consult your doctor for a discussion of these and other risks.

Next: Your Healthcare Team

Your Healthcare Team

If you have been diagnosed with a spinal fracture and have elected to undergo balloon kyphoplasty, you will likely be seen by a GP, who will, in turn, refer you to a spine specialist for the procedure. Although the process of being treated by several different doctors may seem daunting, in reality, it’s relatively simple.

Diagnosis of your spinal fracture is usually made by your GP. Your doctor will examine you and order imaging studies such as x-rays or magnetic resonance imaging (MRI) scan to confirm the diagnosis. Once a diagnosis of spinal fracture has been confirmed, you will be referred to a surgeon or interventionalist who has undergone advanced training to repair broken bones in the spine. 

After the broken bone is repaired, you will be referred back to your GP for treatment of the condition that caused your bone to break.

Generally, doctors performing balloon kyphoplasty first attend a special training course taught by doctors who have extensive experience with the procedure. Orthopaedic surgeons, neurosurgeons, interventional radiologists, interventional neuroradiologists, and pain-management specialists who specialise in treating the spine may perform balloon kyphoplasty. 

Next: Surgery: What to Expect

Surgery: What to Expect – Balloon Kyphoplasty

Before the Procedure

Before the procedure, you will have a medical exam and undergo imaging studies, such as x-rays, to determine the precise location of the fracture.

During the Procedure

Under x-ray guidance, a narrow pathway is made into the fractured bone using a hollow instrument. A small orthopaedic balloon is guided through the hollow instrument into the vertebral body. The incision site is approximately 1 centimetre in length.

Typically, two balloons are used, one on each side of the vertebral body, to better support the bone as it moves back into position and increase the likelihood of deformity correction.

Next, the balloons are carefully inflated in an attempt to raise the collapsed vertebral body and return it to its correct anatomical position. Inflation of the balloons moves the soft, inner bone against the wall of the vertebral body, creating a cavity (space) inside the vertebra.

The cavity is the space created by moving the broken bone with the balloons. Bone cement is then deposited into the cavity to stabilise the fracture.

Once the vertebral body is in the correct position, the balloons are deflated and removed. The cavity is filled with thick bone cement to stabilise the fracture. The bone cement forms an internal cast that holds the vertebral body in place.

Balloon kyphoplasty takes about an hour per fracture level treated. It can be done on an inpatient or outpatient basis, depending on your overall state of health.

After the Procedure

After the procedure, you will likely be transferred to the recovery room for observation.

Patients are typically discharged from the hospital the same day, although sometimes a longer stay is required.

When you go home, you can expect to resume your normal activities, subject to your doctor’s instructions.

Next: Life After Balloon Kyphoplasty