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An Overview of Kyphoplasty

The evolution of materials and methods associated with the success of vertebroplasty to treat vertebral compression fractures resulted in the development of kyphoplasty in 1998.

Kyphoplasty is used to create bilateral bone spaces as well as reduce depressed end plates and restore vertebra’s height in varying degrees. It’s made possible by the use of bilateral balloon bone tamps that are capable of providing pressures that are higher than angioplasty balloons. A doctor can inject a cement mixture that is significantly thicker during a kyphoplasty procedure because he or she can create bilateral bone voids due to the use of the increased pressure. Unlike vertebroplasty, kyphoplasty offers fewer complications that are cement related. Kyphoplasty also possess fewer contraindications than vertebroplasty.

Patient Selection

Doctors can determine if a patient can benefit from kyphoplasty. Both kyphoplasty and vertebroplasty have the same indications, but doctors may recommend kyphoplasty in certain patients where vertebroplasty is not recommended or contraindicated. For example, patients with multiple myeloma, which is characterized by pathological fractures and loose, retro-pulsed fragments and uncertain integrities of bony cortex, should not get vertebroplasty.

In the case of a patient having retro-pulsed fragments, kyphoplasty is useful in the elevation of depressed anterior end plates that results in the anterior reduction of retro-pulsed fragments. Unlike other illnesses, there are certain categories of vertebral compression fractures that have a better chance of being corrected if a treatment such as a kyphoplasty or a vertebroplasty was given, and they include:

  1. Osteoporotic fracture that still requires narcotic analgesia in spite of being given ideal medical treatment after two to six weeks.
  2. Progressive vertebral body collapse on subsequent imaging, specifically if related to elevated pain.
  3. Pathological fractures that are painful and require narcotics of moderate to high dosage for pain management, specifically if a patient has developed a poor tolerance to the narcotics.

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