How Does Kyphoplasty Repair Compression Fractures?

Bones are living organs whose cells grow and die off, replaced by new cells. This renewal occurs throughout your life. Osteoporosis is a disease that develops when more cells die than are created, leaving a cross-section of bone looking like Swiss cheese. 

With loss of density, osteoporosis leaves the bones weak and brittle. You can break them easily in a minor fall or just from sneezing. Spontaneous compression fractures in the spinal vertebrae are a common complication.

At Interventional Pain Center, anesthesiologist and interventional pain medicine physician Dr. James Stephens understands how painful and worrying a compression fracture can be, which is why he offers kyphoplasty, a surgical procedure that restores bones damaged by osteoporosis. Here, he describes what’s involved in the process.

The perils of osteoporosis

If you look under a microscope, healthy bone tissue appears like a honeycomb, with thick walls of tissue and evenly spaced holes. Osteoporosis means “porous bone;” when you examine the tissue from a patient living with the disease, you see thin walls and large, irregularly spaced holes, representing the loss of tissue mass and density. 

Because there’s more space than tissue, the diseased bones break more easily than normal bones. The population at the highest risk for developing osteoporosis from non-controllable causes (i.e., genetics, race) is small, white or Asian, postmenopausal women. The latter is the case because estrogen, a reproductive hormone, helps keep bones strong, and hormone levels plummet when you reach menopause.

Osteoporosis is a “silent disease” because there’s no way to tell if your bones are weak without a bone density scan, called a DXA (pronounced DEXA). 

Breaking a bone (especially in the femur, wrist, or spine) or losing height and/or upper back curvature are all signs you have the disease. If you experience any of these, contact the Interventional Pain Center as soon as possible so we can provide an accurate diagnosis and appropriate treatment.

What is a compression fracture?

Your spine consists of 24 linked, bony vertebrae that contain cushiony discs between each pair. The discs absorb shock when you walk, jump, or turn, preventing the bones from grating against each other. 

If your vertebrae lose density, your spine can start to curve outward in the chest region from the stress, causing a humpback (kyphosis). In addition, the vertebrae may collapse on each other, often spontaneously — a compression fracture. These fractures are extremely painful and can prevent you from doing something as simple as getting out of bed.

Compression fractures usually form in the thoracic (chest) spine, which includes the T1-T12 vertebrae; however, they can also occur in the lumbar (lower back) spine, L1-L5, due to its more significant movement.

How does kyphoplasty repair compression fractures?

Kyphoplasty is a minimally invasive surgical procedure that addresses spinal compression fractures. The procedure has three goals: stabilize the fractured vertebra(e), restore the vertebrae to their normal height, and relieve the pain from the fracture. The procedure takes about an hour per vertebra to fix.

For the procedure, you lie face down on the operating table, and we give you either a sedative or general anesthesia to keep you comfortable. Dr. Stephens makes a small, half-inch incision over the affected area.

Next, using X-ray guidance, the doctor inserts a narrow tube into one side of the fractured vertebra. Then, he threads an uninflated balloon through the tube and into the collapsed vertebral body. 

At its destination, Dr. Stephens inflates the balloon to create an open cavity inside the bone, which restores the height lost due to vertebral collapse. He then deflates the balloon and pulls it back out of the tube, leaving the cavity behind.

Finally, he injects PMMA, a type of bone cement, into the new cavity to shore up the walls and ensure the vertebra doesn’t collapse again. He may repeat the process on the other side of the vertebra to ensure uniform stability. 

Once the cement hardens, we move you to recovery and monitor you for a bit. Usually, you can go home the same day, and Dr. Stephens gives you detailed written aftercare instructions.

Some patients feel immediate pain relief from the procedure, while others need a day or two before their pain level drops. Once you’re home, you can resume most of your daily activities, though we recommend you avoid strenuous activities like lifting, driving, and intense exercise for at least six weeks.

If you have osteoporosis and are at risk for compression fractures, or if you have a fracture and need treatment, the Interventional Pain Center can help. Call the office at 405-759-8407 to schedule an evaluation with Dr. Stephens, or use our online booking tool today.