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Kyphoplasty and Vertebroplasty are minimally invasive surgical procedures designed to stabilize vertebral compression fractures. The core principle involves injecting a specialized orthopedic cement (bone cement) into the fractured or collapsed vertebral body.
The general procedure is as follows:
These procedures are performed in a sterile operating room environment, typically under local or general anesthesia. Local anesthesia is often preferred for suitable patients. A small, minimally invasive incision is made over the fractured vertebra to allow access for the specialized needle. Patient positioning (prone or lateral) is determined by the specific fracture location.
Under continuous fluoroscopic (X-ray) guidance, a needle is carefully advanced into the fractured vertebra, ensuring safe distance from surrounding neural structures to prevent injury. Precise needle placement is confirmed radiographically, often supplemented by patient feedback to monitor pain levels.
Once optimal needle position is achieved, the orthopedic cement is prepared and injected into the vertebral body using a specialized syringe. Up to this point, the initial procedural steps for both Kyphoplasty and Vertebroplasty are similar.
Vertebroplasty: In this technique, the liquid bone cement (polymethylmethacrylate, PMMA), usually 3-5 grams, is directly injected through the needle into the fracture site. The cement rapidly hardens, typically within 20-25 minutes, thereby stabilizing the vertebra.
Kyphoplasty: This method includes an additional step before cement injection. A wider needle introduces a specialized balloon (bone tamp) into the fractured vertebra. The balloon is inflated to gently restore vertebral height and create a cavity. After deflation and removal of the balloon, bone cement is injected into this created space, similar to Vertebroplasty.
While both procedures aim for stabilization, Kyphoplasty generally offers greater height restoration. Vertebroplasty typically achieves a 4-7% increase in vertebral height, whereas Kyphoplasty can restore up to 10%.
How are Kyphoplasty and Vertebroplasty surgeries performed?
The general procedure is as follows:
These procedures are performed in a sterile operating room environment, typically under local or general anesthesia. Local anesthesia is often preferred for suitable patients. A small, minimally invasive incision is made over the fractured vertebra to allow access for the specialized needle. Patient positioning (prone or lateral) is determined by the specific fracture location.
Under continuous fluoroscopic (X-ray) guidance, a needle is carefully advanced into the fractured vertebra, ensuring safe distance from surrounding neural structures to prevent injury. Precise needle placement is confirmed radiographically, often supplemented by patient feedback to monitor pain levels.
Once optimal needle position is achieved, the orthopedic cement is prepared and injected into the vertebral body using a specialized syringe. Up to this point, the initial procedural steps for both Kyphoplasty and Vertebroplasty are similar.
Vertebroplasty: In this technique, the liquid bone cement (polymethylmethacrylate, PMMA), usually 3-5 grams, is directly injected through the needle into the fracture site. The cement rapidly hardens, typically within 20-25 minutes, thereby stabilizing the vertebra.
Kyphoplasty: This method includes an additional step before cement injection. A wider needle introduces a specialized balloon (bone tamp) into the fractured vertebra. The balloon is inflated to gently restore vertebral height and create a cavity. After deflation and removal of the balloon, bone cement is injected into this created space, similar to Vertebroplasty.
While both procedures aim for stabilization, Kyphoplasty generally offers greater height restoration. Vertebroplasty typically achieves a 4-7% increase in vertebral height, whereas Kyphoplasty can restore up to 10%.