What is a kyphoplasty?
A kyphoplasty is a treatment that involves the use of cement to stabilize and treat a compression fracture of a vertebrae (one of the bones of the spinal column).
What is the purpose of a kyphoplasty?
A kyphoplasty is used to stabilize a compression fracture of a vertebrae. When a vertebrae is fractured, that fracture can continue to worsen or have a difficult time healing because almost any movement of the body can stress the fracture.
How is the procedure performed?
You will be placed on the procedure table. The injection site is sterilized with either iodine or chlorhexadine. The site to be injected is numbed with a local anesthetic, and a needle is directed to the target area. X-ray guidance is used to ensure proper placement and positioning of the needle within the fractured bone. A tool is then utilized to create a cavity inside the bone, and help the bone return to its normal anatomic shape. Cement is then used to fill that cavity and maintain the shape of the bone. The cement fully hardens within a few minutes. The needle is then removed, and you will be taken to recovery.
Will the procedure be painful?
The procedure can be painful and we therefore provide the option of receiving IV sedation. IV sedation, combined with local anesthetic, can make the injection nearly pain free. It allows you to remain very still during the procedure, which can also make the injection easier, faster, and more successful. If you decide to have IV sedation, you must have a driver to get you home safely afterwards. In addition, you cannot have anything to eat or drink within 6 hours of your appointment (clear liquids are allowed until 2 hours before the procedure). If you take medications for diabetes, these medications may need to be adjusted the morning of the procedure. Your primary care physician can help you with this adjustment.
What are the discharge instructions?
If you received IV sedation do not drive or operate machinery for at least 24 hours after the procedure. You may return to work the next day following your procedure. You may resume your normal diet immediately. Do not engage in any strenuous activity for 24 hours. You should, however, engage in moderate activity that typically causes pain. If the block works, those activities should not be painful for several hours after the injection. Do not take a bath, swim, or use a hot tub for 24 hours (you may take a shower). Call the office if you have any of the following: severe pain afterwards (different than your usual symptoms), redness/swelling/discharge at the injection site(s), fevers/chills, difficulty with bowel or bladder functions.
What are the risks and side effects?
The complication rate for this procedure is very low. Whenever a needle enters the skin, bleeding or infection can occur. Some other serious but extremely rare risks include paralysis and death.
You may have an allergic reaction to any of the medications used. If you have a known allergy to any medications, especially local anesthetics, notify our staff before the procedure takes place.
You may experience any of the following side effects up to 4 hours after the procedure:
- Leg muscle weakness or numbness may occur due to the local anesthetic affecting the nerves that control your legs (this is a temporary affect and it is not paralysis). If you have any leg weakness or numbness, walk only with assistance in order to prevent falls and injury. Your leg strength will return slowly and completely.
- Dizziness may occur due to a decrease in your blood pressure. If this occurs, remain in a seated or lying position. Gradually sit up, and then stand after at least 10 minutes of sitting.
- Mild headaches may occur. Drink fluids and take pain medications if needed. If the headaches persist or become severe, call the office.
- Mild discomfort at the procedure site can occur. This typically lasts for a few hours but can persist for a couple days. If this occurs, take anti-inflammatories or pain medications, apply ice to the area the day of the procedure. If it persists, apply moist heat in the day(s) following.
The side effects listed above can be normal. They are not dangerous and will resolve on their own. If, however, you experience any of the following, a complication may have occurred and you should either contact your doctor. If he is not readily available, then you should proceed to the closest urgent care center for evaluation:
- Severe or progressive pain at the injection site(s)
- Arm or leg weakness that progressively worsens or persists for longer than 8 hours
- Severe or progressive redness, swelling, or discharge from the injections site(s)
- Fevers, chills, nausea, or vomiting
- Bowel or bladder dysfunction (i.e. inability to urinate or pass stool or difficulty controlling either)
How long does it take for the procedure to work?
You should feel relief from the fracture pain immediately. You may have some inflammation in the area of the fracture that can cause persistent pain. Cement stabilization will not alleviate any pain caused by that inflammation. The inflammation will continue to subside over the following week or two, which will lead to continued improvement in pain during that time.