Getting Back to a Healthy Spine
May 2004 — They may look intimidating, but don't let the words "vertebroplasty" and "kyphoplasty" scare you. The two procedures — pronounced "ver-TEE-bro-plas-tee" and "KI-fo-plas-tee" — are giving relief to hundreds of people who suffer spinal deterioration due to osteoporosis. Most common in elderly women, osteoporosis is a disease in which the bones lose density and become brittle. A familiar indicator is a compression fracture, or collapse of the vertebrae, resulting in stooped posture.
"In most cases, people have a compression fracture because their bones are soft," says Greg Zorman, MD, Chief of Neurosurgery at Memorial Regional Hospital. "All they have to do is sit down too hard, sneeze too hard, lift something or fall, and they have a compression fracture. It's very painful."
Until recently, the condition was also largely untreatable. But kyphoplasty and vertebroplasty have changed that. "Now we have more options available for people we used to treat with bed rest, physical therapy or medication," says Dr. Zorman.
How They Work
Vertebroplasty and kyphoplasty are slightly different in approach and application. With vertebroplasty, the doctor injects a medical cement into the spine at the fracture. The substance fills the fractured vertebrae and then hardens to stabilize the bones.
Kyphoplasty is more complex. With X-ray guidance, the doctor inserts a tiny balloon into the spine at the fracture. As the balloon inflates, the collapsed vertebrae rise; the balloon is removed and the space is filled with the medical cement.
"Vertebroplasty arrests the collapse, but can't correct what has already happened. We use vertebroplasty if there is not much of a collapse to correct," "Kyphoplasty is newer and can reconstruct the normal curvature of the spine." says Dr. Zorman.
The medical cement, called methylmethacrylate polymer, is injected through a small needle inserted into the spine. The hospital receives it as a powder, which is mixed with a liquid just before injection. It solidifies quickly, becoming harder than natural bone in about 10 minutes.
Recovery Made Quick and Easy
Both vertebroplasty and kyphoplasty are minimally invasive. Vertebroplasty requires only local anesthetic and a small incision. After the procedure is completed, the patient must lie facedown for two to three hours. Stitches are usually not required.
Kyphoplasty is much the same in regard to the small incision and recovery time. However, it requires the insertion of a small tube for guiding the balloon into place.
Success rates of 80 to 90 percent are typical with both procedures. In addition to deterring further collapse of the spine, many patients experience pain relief and increased mobility immediately after rising from the operating table.
Dr. Zorman is impressed with the procedures. "I marvel at the ingenuity of my research colleagues," says Dr. Zorman. "You hear about new techniques and at first you think, 'How in the world are we going to do that?' And later you're saying, 'Why didn't I think of that?'"
To find out more about treatment options for osteoporosis and other spinal conditions, talk to your doctor. For a referral to a physician, please call the Memorial Physician Referral Service at (800) 944-DOCS.