02 Nov Possible Complications of Kyphoplasty
Kyphoplasty is a minimally invasive spinal procedure in cases where vertebral bodies have lost height due to a compression fracture. This procedure along with vertebroplasty is done to control compression fracture-related pain. In both cases, an injection of acrylic cement is placed in the bone, but kyphoplasty uses a balloon to blow up space in an attempt to restore some or all of the height lost. Fluoroscopy, a small camera, is inserted a picture is projected on a screen to guide the doctor during the procedure. The treatment is considered controversial within the medical community.
The treatment objectives include:
- improved function
- decreased pain
- restored the anatomy
- reducing and stabilizing the compression fracture
- increased vertebral height
- decreased spinal deformity
Kyphoplasty is done when patients with recent compression fractures that are due to osteoporosis, angiomas, myelomas, metastasis (to name a few), and pain response to conservative treatment was poor. Best results are achieved when treatment is done within 3 months (or less) of the vertebral collapse.
A leak of cement can result in the compression of the spinal cord. This can cause severe pain, tingling, weakness, and even paralysis when it leaks into surrounding tissues or structures. Any leakage of cement can cause severe neurological or pulmonary complications. However, in most cases pain relief is immediate and the risk of complications is low. General minor side-effects soreness and redness around the surgical site.
Some associated risks include leaking of acrylic cement to the outside of the vertebral body. Severe complications are rare and include:
- numbness and tingling
- paralysis due to misplacement of the needle or cement
- new compression fractures
- pulmonary embolism
- spinal cord injury
- Cerebrospinal fluid leakage
- transient adult respiratory distress syndrome
The procedure is used to fill holes in the spinal column left from osteoporosis, a bone-thinning disease that greatly increases the risk of bone fractures. Kyphoplasty and vertebroplasty are similar but in the later, a surgical instrument (instead of a balloon) is used to expand the vertebra before injecting the cement a newly made space. These procedures are commonly used in patients who have been unsuccessful with standard osteoporosis treatments.
Osteoporosis is a degenerative bone disease that causes bones to become brittle leads to frequent fractures and other complications.
Traditional treatments of osteoporosis include:
- Calcium and vitamin D supplements
- HRP (hormone replacement)
- drugs like Evista, Fosamax, Miacalcin, or Actonel