Kyphoplasty

Abstract

A variant of vertebroplasty known as "kyphoplasty" has been suggested for correcting vertebral compression fractures. A balloon placed inside the vertebral body is inflated to create a cavity, thereby restoring vertebral body height and allowing low-pressure cement injection. This procedure is gaining popularity in the United States. Over 1000 patients had been treated by the end of 2000. However, kyphoplasty is costly (chiefly because the balloon is disposable) and has not been evaluated in carefully designed studies. Although retrospective findings have been reported as highly promising, they are not sufficient to validate this procedure. The principle is innovative and the procedure deserves further investigation as a potentially effective means of correcting loss of vertebral height. Furthermore, use of a bone substitute instead of cement deserves investigation.

Vertebroplasty and kyphoplasty: complementary techniques for the treatment of painful osteoporotic vertebral compression fractures. A prospective non-randomised study on 154 patients

“…On the one hand, it is suggested that VP should be considered after a course of 3 months of conservative treatment [16]. On the other, supporters of KP suggest that the procedure should be done within 3 months from fracture to increase the likelihood of a favourable outcome [10], or even within a few days from fracture to achieve a good restoration of vertebral height [11]. However, in a recent prospective series [14] patients treated with KP had chronic pain of more than 12 months duration, and still there were improvements in vertebral body height, pain and mobility compared to the preoperative status.…”

“…KP was always performed under general anaesthesia. The surgical techniques did not differ from those already described for VP and KP with PMMA [5,10,11,15,21], except for the use of the inflatable bone tamp in KP, with identical cannulae and PMMA density. Patients were mobilised as soon as tolerated on the same day of surgery and discharged on the following day.…”

Percutaneous stabilization of lumbar spine: a literature review and new options in treating spine pain

“…54 Posterolateral approach is preferred; an alternative approach could be the transpedicular route. 55 A 10-gauge cannula is inserted into the vertebral body under fluoroscopic or CT guidance. The inner cannula is removed, and a trocar is inserted through the cannula and is used to create a path into the vertebral body.…”

Treatment of type-A3 amyelic thoracolumbar fractures (burst fractures) with kyphoplasty: initial experience

“…Vertebroplasty is associated with an increased risk of fracture at adjacent vertebral levels as a result of spinal imbalance [2]. Kyphoplasty reduces the risk both of adjacent fractures and of cement leakage (into the vertebral or foraminal canal) with venous embolism because the cement is injected into a preformed cavity [3,4]. The unique features of the technique and the positive results achieved in treating osteoporotic and neoplastic vertebral lesions prompted us to test its use in treating traumatic type-A3 thoracolumbar fractures according to Magerl classification [5] without neurological deficit.…”