What is the Difference Between a Vertebroplasty and Kyphoplasty?

24 Nov What is the Difference Between a Vertebroplasty and Kyphoplasty?

Vertebroplasty vs Kyphoplasty

Vertebroplasty and kyphoplasty are two surgical procedures where bone cement is injected into collapsed spinal bones, called vertebrae, in order to provide relief of pain caused by pathologies such as compression fractures. Although these are similar surgeries, there are important differences that need to be mentioned.

The following information will relate to the characteristics and steps of these two surgical procedures so that one can see the similarities and difference between.

Vertebroplasty

• Performed by a spinal surgeon or interventional radiologist.
• It is a minimally invasive procedure where local anesthetic and light sedation is given to the patient. Patients who can’t tolerate sedatives usually have the procedure done under a local anesthetic only.
• Patients are usually discharged the same or next day.
• Bone cement is injected via a biopsy needle that is inserted through the skin and muscle layers of the back into the fractured or collapsed bone to “inflate” the collapse.
• The needle is guided into the correct anatomical landmark using the imaging technique known as fluoroscopy.
• The cement is injected into the collapsed bone in order to provide strength and stability to the structure.
• Used to be performed as an open procedure but this caused complications in patients and the safer and more effective percutaneous procedure was developed.

Kyphoplasty

• Similar to vertebroplasty in that it is also a minimally invasive procedure where a needle is inserted through the skin and under fluoroscopy is guided into the collapsed vertebra.
• The collapsed bone is in a kyphotic position so the difference in the procedures is that instead of just injecting the cement into the vertebra, in a kyphoplasty a small balloon is placed into the vertebral column and inflated in order to restore the height and angle of the collapsed bone.
• When the correct shape and height is achieved, the open space formed by the inflated balloon will then be directly filled with the bone cement in order to strengthen and support the position of the vertebra.
• Where vertebroplasty is performed to basically manage the pain caused by a collapsed vertebra, kyphoplasty provides actual treatment of the bone.

Success rate of vertebroplasty

In a study conducted on the percutaneous vertebroplasty success rate of patients with vertebral compression fractures due to osteoporosis, the following findings were made:¹

• The vertebroplasty procedure was well tolerated by 62 participants in the study who underwent a total of 73 procedures to manage 92 collapsed vertebrae.
• Not one of the participants died within 30 days after the procedure was performed.
• Patients reported decreased pain over one week, one month, three months, six months, and one year after the procedure was performed.
• The amount of oral medication used for pain relief by the participants also decreased over these time periods.
• Five new fractures were reported in five of the study participants at follow-up visits after the procedure.

The conclusion was that vertebroplasty offered rapid pain relief in patients with chronic painful vertebral compression fractures due to osteoporosis and this was sustained for at least one year.

Reference

1. Tan H-Y, Wang L-M, Zhao L, Liu Y-L, Song R-P. A prospective study of percutaneous vertebroplasty for chronic painful osteoporotic vertebral compression fracture. Pain Research & Management : The Journal of the Canadian Pain Society. 2015;20(1):e8-e11.