Kyphoplasty is a minimally invasive procedure designed to treat painful vertebral compression fractures by restoring the height of the collapsed vertebra and stabilizing the fracture with medical-grade bone cement. Unlike traditional open spine surgery, kyphoplasty requires only a small skin incision and is performed under real-time fluoroscopic guidance, allowing patients to experience dramatic pain relief within hours of the procedure.
Vertebral compression fractures are most commonly caused by osteoporosis, a condition that weakens bone density and makes vertebrae susceptible to collapse under normal physiologic loads. These fractures may also result from metastatic cancer involving the spine, multiple myeloma, or traumatic injury. When a vertebra collapses, it causes severe axial back pain, reduces spinal height, and can lead to a progressive kyphotic deformity (hunched posture) that impairs pulmonary function, mobility, and quality of life.
At Interventional Pain Consultants, kyphoplasty is performed by board-certified, fellowship-trained interventional pain specialists with extensive experience in spinal interventions. The procedure has been extensively studied and validated as a safe and effective treatment for vertebral compression fractures, with published clinical outcomes demonstrating significant pain reduction, improved functional status, and restoration of vertebral body height in the vast majority of treated patients.
Under moderate sedation and fluoroscopic guidance, the physician creates a small skin incision over the pedicle of the affected vertebra. A specialized bone biopsy needle is advanced through the pedicle into the vertebral body using a transpedicular or extrapedicular approach. Once the needle tip is positioned within the fractured vertebral body, a balloon tamp (Kyphon balloon) is carefully inflated under controlled pressure monitoring.
The balloon inflation compresses the cancellous bone within the vertebral body, creating a cavity and restoring vertebral body height by elevating the endplates. Following balloon deflation and removal, the cavity is filled with high-viscosity polymethyl methacrylate (PMMA) bone cement under low pressure. The cement hardens within 10-15 minutes, providing immediate mechanical stabilization of the fracture. The entire procedure typically treats one to three levels per session and takes approximately 30-45 minutes per level.
Patients are positioned prone on the procedure table and receive intravenous sedation for comfort throughout the procedure. The skin over the lower back is thoroughly cleansed with antiseptic solution, and the physician numbs the skin and deeper tissues with local anesthetic before making the small incision. During needle placement and cement injection, the physician communicates continuously with the patient to ensure comfort and safety.
After the procedure, patients are observed in a recovery area for approximately 1-2 hours before being discharged home. Most patients are able to sit up and walk within hours of the procedure. A responsible adult must accompany the patient home, and patients are provided with detailed post-procedure instructions regarding activity restrictions and warning signs to monitor.
The recovery from kyphoplasty is remarkably rapid compared to open surgical alternatives. Many patients report significant improvement in pain within the first 24 hours following the procedure, and the majority of patients experience maximum benefit within 48-72 hours. Patients are encouraged to resume light ambulation on the day of the procedure and gradually increase activity as tolerated over the following week.
Heavy lifting (greater than 10 pounds), bending at the waist, and twisting movements should be avoided for at least 4-6 weeks following the procedure to allow the cement-bone interface to achieve maximum stability. Most patients return to their normal daily activities within 1-2 weeks, and many are able to discontinue or significantly reduce their use of narcotic pain medications following the procedure. A follow-up visit is typically scheduled at 2-4 weeks to evaluate clinical response and assess the need for treatment of additional levels or adjacent vertebrae.
Kyphoplasty is most effective when performed within 3-6 months of fracture onset, though patients with chronic painful non-union fractures may also benefit. Ideal candidates have focal midline back pain that correlates with MRI evidence of acute or subacute vertebral edema on STIR sequences. Contraindications include active systemic infection, uncorrectable coagulopathy, fracture with retropulsion of bone fragments causing neurologic compromise, and allergy to any components of the bone cement.
At Interventional Pain Consultants, we take a comprehensive approach to the management of vertebral compression fractures. In addition to performing kyphoplasty, we work closely with primary care physicians and endocrinologists to optimize the medical management of osteoporosis, including calcium and vitamin D supplementation, bisphosphonate therapy, and fall prevention strategies to reduce the risk of future fractures.
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