Kyphoplasty and Vertebroplasty
The Condition: Spinal Fractures
Vertebral compression fractures are a very common problem in the United States affecting over 700,000 patients per year. The most common related cause in these patients is osteoporosis. The second most common cause is cancer, with multiple myeloma being the most common form. Because of this association, we routinely submit biopsy samples obtained at the time of the procedure.
Balloon Kyphoplasty is a minimally invasive orthopedic treatment that stabilizes the fracture, thereby reducing the pain and correcting the deformity when possible. This procedure is performed at UNC REX Hospital on an outpatient or inpatient basis (depending on complicating medical conditions). In this procedure the fractured bone is entered with a special needle and a balloon is introduced into the center of the bone. The balloon is used to create a “void” or space in the bone as well as to correct the deformity, if possible. The space is then filled with bone cement (methyl methacrylate), which stabilizes the bone. Pain relief is dramatic and nearly complete in over 80% of patients.
Vertebroplasty does not use the balloon and does not attempt to correct the deformity. In some cases this simpler procedure is more appropriate. Our involvement with these patients begins either in the hospital with a consult or with a direct referral to our clinical office in Cary. We evaluate the patient, obtain and review appropriate imaging studies and laboratory studies, and make recommendations to the patient and the referring physician. Optimal results are obtained if we see these patients within a few weeks of their fracture. It has been our experience that the sooner we get patients out of pain, the better they do, as prolonged use of narcotics in these often elderly individuals can have profoundly negative consequences including constipation, decreased mentation, risk of falling, and acceleration of underlying osteoporosis due to immobility. We make every effort to expedite the treatment of patients who are in pain. After the procedure is performed, our job does not end. We follow the patient in our Cary clinical office, review the labs and other studies, and place the patient on appropriate therapy or make referrals to the appropriate clinical specialists.