What are Vertebral Compression Fractures?
Vertebral compression fractures, or VCF’s, occur when bones in the spine are broken. They can occur from trauma, such as a car accident or fall, but are most commonly the result of osteoporosis which causes weakened bones. VCF’s can also occur from other conditions that cause weakened bones, such as certain cancers or long term steroid use.
Compression fractures occur most commonly in the mid to lower back due to the weight bearing load of the spine. This load can cause vertebrae to become crushed when bone weakness is present. When the vertebra is crushed, it fractures and falls on top of the vertebra below it. Symptoms range from severe pain to no pain at all. Compression fractures can lead to progressive spinal deformity. When multiple fractures occur, a condition known as Kyphosis, or dowager’s hump, causes the back to become rounded and bent forward. This forward curvature of the spine can affect quality of life making it more difficult to breathe, eat, walk, or sleep.
What is Osteoporosis?
Osteoporosis is a degenerative condition associated with aging that causes loss of bone mass. This leads to weakened and brittle bones that break easily by minimal
trauma or by no trauma at all. Osteoporosis is most common in post-menopausal women but can also occur in older men or patients on long term steroid therapy.
Balloon Kyphoplasty Indications
Balloon Kyphoplasty Surgery is an elective surgery to treat painful compression fractures of the spine that have not responded to conservative treatment measures such as rest, medication, or back bracing.
Indications for Balloon Kyphoplasty surgery include:
- Vertebral Compression Fractures due to osteoporosis.
- Vertebral Compression fractures caused by weakened bones in patients with diagnoses such as Metastatic cancer, kidney disease, lymphoma, and multiple myeloma.
- Severe pain and deformity related to a vertebral fracture that is unrelieved by conservative treatments such as pain medications and bracing.
Evaluating the source of back pain is critical in determining your options for relief of the pain and the location of where to perform surgery.
Your surgeon will perform the following:
- Medical History
- Physical Examination
Diagnostic Studies to confirm a vertebral fracture and its cause may include:
- X-rays: a form of electromagnetic radiation that is used to take pictures of bones.
- MRI: magnetic and radio waves are used to create a computer image of soft tissue such as nerves and ligaments.
- CT Scan: This test creates 3D images from multiple x-rays and shows your physician spinal structures not seen on regular x-ray.
- Bone Density Test: A test used to diagnose osteoporosis using special x-rays to determine bone density or strength.
Balloon Kyphoplasty is a minimally invasive surgical procedure to alleviate severe pain and disability resulting from vertebral compression fractures.
The ultimate goal of the surgery is to:
- Alleviate or reduce the patient’s pain
- Restore the fractured vertebra to its pre-fracture height
- Improve spine functionality
- Restore normal alignment of the spine
The surgery is performed under sterile conditions in the operating room with the patient under general or local anesthesia and lying face down on the operating table.
- Your surgeon will make 2 very small incisions over the fracture site.
- A balloon catheter is inserted through the incisions and into the body of the affected vertebra.
- The balloons are inflated with a liquid, under guidance by fluoroscopic x-ray, inside the collapsed vertebra. This creates a cavity and helps restore the vertebra to its pre-fracture height and alignment.
- The surgeon then deflates and removes the balloons leaving an open cavity.
- Bone cement is then inserted through the catheters into the open cavity.
- Once the cement is carefully placed, the catheters are removed and the cement will harden in minutes.
Many patients feel immediate pain relief following Balloon Kyphoplasty surgery. Others may take a few days or weeks before showing improvement.
- You will be allowed to get up and walk once you awaken.
- Normally you will stay in the hospital overnight, however some patients go home the same day.
- Pain medication will be given to make you comfortable for the first few days.
- You will be restricted from heavy lifting or strenuous activities for the first 6 weeks.
- A postoperative rehabilitation program may be prescribed by your doctor to strengthen spinal muscles after two weeks.
If you have been diagnosed with Osteoporosis, it is important for you to follow up with your physician for medical treatment of your condition.
Risks and complications
- As with any major surgery there are potential risks involved. The decision to proceed with the surgery is made because the advantages of surgery outweigh the potential disadvantages.
- It is important that you are informed of these risks before the surgery takes place.
Complications can be medical (general) or specific to spinal surgery.
Medical complications include those of the anesthetic and your general well being. Almost any medical condition can occur so this list is not complete. Complications include
- Allergic reactions to medications
- Blood loss requiring transfusion with its low risk of disease transmission
- Heart attacks, strokes, kidney failure, pneumonia, bladder infections
- Complications from nerve blocks such as infection or nerve damage
- Serious medical problems can lead to ongoing health concerns, prolonged hospitalization, or rarely death.
Specific complications of Balloon Kyphoplasty surgery include:
- Nerve damage or spinal cord injury from misplaced instruments
- Nerve damage or spinal cord injury from leaking cement
- Deep or superficial wound infection