KYPHOPLASTY & VERTEBROPLASTY
Vertebroplasty is a procedure where bone cement is injected into a weakened vertebra either from a spinal compression fracture, osteoporosis or spinal tumor, commonly metastasis. The surgeon has to be very careful that the bone cement stays within the vertebral body and does not flow into the spinal canal, with serious neurological consequences. There is also a small risk of cement embolization causing pulmonary emboli. It is largely a safe procedure if done by an experienced spine surgeon.
Vertebroplasty can also be done in addition or through the pedicle stabilizing screw in cases of osteoporosis.
Kyphoplasty, also referred to as balloon kyphoplasty, involves insertion of a catheter percutaneously into the vertebral body. The tip of the catheter has a balloon which is inflated allowing a space to be created within the vertebral body. Into the space cement is injected. Thus, making it safer than vertebroplasty.
Both these procedures are done in the operating room with c-arm monitoring.
CASE STUDY 1
A 75 yrs old lady presented with complaints of back pain from a D12 vertebral fracture and underwent D12 kyphoplasty.
CASE STUDY 2
A 79 yrs. old lady presented with the history of low back ache and left leg pain for 6 months. She had a past history of low backache pain 2 years previously which resolved after lumbosacral blocks and was pain free thereafter till onset of present set of complaints. She was a known case of severe osteoporosis. She was evaluated and was planned for L5-S1 decompression and in-situ fusion and pedicle screw stabilization (and bone cement insertion through L5 screws). Post-operatively she did well except for sacroiliac pain for which S.I blocks were performed which relieved her of her pain. She is being treated for osteoporosis.
Pre-op MRI Image showing the L5-S1 disc prolapse with
listhesis. Encircled - L5-S1 disc prolapse.
Post- op x-ray Image showing pedicle screws at L5-S1and bone
cement in L5 body. Encircled - bone cement in L5 body.