Information about your procedure:
Following your recent investigations and consultation with your spinal surgeon, your scans have revealed that you have one or more fractured vertebrae (bones of the spine). This could have been caused by osteoporosis, injury to your back or less commonly cancer, as these can weaken a bone’s structure.
In certain circumstances if the condition worsens, it can lead to collapse or narrowing of the spinal canal and pressure on the spinal nerves. This can cause pain, numbness, increased sensitivity or even weakness of the muscles down the leg supplied by that particular spinal nerve (sciatica). Kyphoplasty is a procedure where bone cement is injected into a fractured vertebra in order to stabilise it and reduce the pain.
About the procedure
The procedure is carried out under intravenous sedation and with the patient lying on their stomach. The skin on the back is cleaned with antiseptic solution. Live X-ray and contrast (which is a kind of dye that the x-ray can see) are used as guidance to direct the needle. There will be a small incision for each vertebra requiring treatment. A hollow needle is then passed down through the muscle into a bony passage (pedicle), which goes to the front of the vertebral body.
Risks and complications
Risks are rare but include the following:
Leakage of the cement outside the bone, which could cause thermal and pressure problems in the spinal canal. This in turn could cause neurological problems and in extreme cases, paralysis
Travelling of particles of cement, air or bone marrow into the blood vessels causing a blockage (embolisation)
Superficial wound infections may occur in 2–4% of cases. These are often easily treated with a course of antibiotics. Deep infections may occur in < 1% of cases. These can be more difficult to treat with antibiotics alone and sometimes patients require more surgery
Bleeding; you must inform your consultant if you are taking tablets used to thin the blood, such as warfarin, aspirin or clopidogrel
The increased strength in the vertebra following kyphoplasty may increase the chances of the adjacent vertebral body fracture in the future
Cement sensitivity, which could cause the heart to have irregular beats. This could, in extreme cases, bring on a cardiac arrest and death
What to expect in hospital
Immediately after the procedure you will be taken on your bed to the recovery ward where nurses will monitor your blood pressure and pulse. Oxygen may be given to you through a facemask to help you wake up after the sedation. Once back on the ward and when you are fully awake you will be allowed to get out of bed.
You will normally be discharged home or to your referring hospital a few hours after your procedure, when you and your nurse are happy with your mobility and basic observations. In case you are discharged home, please arrange for either a friend or relative to collect you from the hospital, as driving yourself or taking public transport is not advised for 48 hours after the sedation. A responsible adult should remain with you overnight. In case you are discharged home, you will be given simple analgesia to take with you.
In general, you may return to work in 2-3 days if this is sedentary and provided that you are comfortable. We will provide a sick note at your request on the day of the procedure, if necessary.
Follow-up in 6 weeks after the procedure