What Is Kyphoplasty?
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Kyphoplasty - Uses, Procedure, Benefits, Risks and Limitations

Published on Jul 28, 2022 and last reviewed on Jan 31, 2023   -  6 min read


Kyphoplasty is a surgical method that is used to treat vertebral fractures. This article reviews the procedure in detail.

Kyphoplasty - Uses, Procedure, Benefits, Risks and Limitations

What Is Kyphoplasty?

Vertebrae make the backbone of our body, also known as the spine. The spine is a vital body part as it supports and stabilizes the entire body. A vertebral compression fracture could result from weak bones, as seen in osteoporosis or bone cancer. This weakness in the bone could result in vertebral collapse and any form of physical strain such as sneezing, coughing, or lifting heavy objects that could result in a fracture. It can also be caused by a direct injury. A fracture in the vertebrae could result in severe consequences such as severe pain, reduced or complete loss of function, difficulty in breathing, decreased physical activity, and depression. Hence, prompt and accurate management is crucial to restoring the functions and thereby an improved quality of life.

Kyphoplasty is a minimally invasive surgical management used to treat compression vertebral fractures. Kyphoplasty helps alleviate pain, stabilizes the vertebra, and also helps in restoring the vertebral height loss due to compression fracture. In this procedure, the fractured bone is held together using a bone cement called polymethylmethacrylate. Once the cement hardens, it strengthens the vertebra and stabilizes it.

Where Is Kyphoplasty Used?

Kyphoplasty is usually indicated in pain associated with vertebral fractures alone and not with any other conditions such as disc herniation or arthritis, or other spinal problems. It is used under the following conditions:

  • Vertebral compression fracture associated with osteoporosis.

  • Vertebral fracture due to metastatic or primary bone cancer.

  • Vertebral vascular tumor.

  • When palliative measures such as rest, back bracing, and medications have proved ineffective.

What Are the Instructions for the Patients Before the Procedure?

  • Kyphoplasty procedure is most effective when done within the first week of a fracture, as with time, the bone may harden and heal but in a collapsed position.

  • A physical examination and diagnostic imaging will be required to confirm the presence of a fracture.

  • The doctor may take a complete history and evaluate the patient clinically to check the stability of the spine.

  • X-rays, computed tomography (CT), and magnetic resonance imaging (MRI) may be required to assess the extent of damage caused.

  • A bone scan may be required in patients with osteoporosis.

  • The patient should disclose any history of allergy to medications, latex, or general anesthesia.

  • Patients should inform the doctor regarding the medications, supplements, and over-the-counter drugs taken by them.

  • Patients may be advised to stop non-steroidal anti-inflammatory drugs such as Ibuprofen and blood thinners, including Aspirin, a week before the surgery.

  • Presurgical blood tests may be required.

  • Smoking and drinking alcohol must be stopped a week before the surgery.

  • Patients should not eat or drink for six hours before the procedure. Medications can be taken with sips of clear liquid.

  • The patient can wear loose and comfortable clothes. They should remove any jewelry and accessories before the procedure.

How Is the Procedure Done?

  • Kyphoplasty is an outpatient procedure performed by an interventional radiologist or a neuroradiologist.

  • Each vertebral body may take an hour for the procedure to complete.

  • The patient will be given a hospital gown to wear and will be taken to the surgical room.

  • The patient would be asked to lie face down on the examination table. Blood pressure, heart rate, and oxygen levels would be monitored.

  • An intravenous (I.V) line would be established in the arm, and a mild sedative would be administered through it along with other medications.

  • The treatment site would be cleaned, shaved, and sterilized with an antiseptic solution.

  • The area may be anesthetized using a local anesthetic.

  • A half-inch incision will be made on the skin at the site, and a hollow needle, also known as a trocar, will be inserted through the incision with the help of a fluoroscope.

  • The needles will be advanced to the site at an angle to avoid the spinal cord.

  • Once the needle is in place, an inflatable balloon will be inserted through the needle into the fracture site.

  • The balloon would then be inflated to create space and thereby increase the height of the collapsed vertebra.

  • The balloon is then removed, and bone cement, namely polymethylmethacrylate, is injected into the cavity created by inserting the balloon.

  • The cement usually hardens in 20 minutes, after which X-rays or CT may be done to confirm its position and to check for any leakage.

  • The needle should be withdrawn before the cement hardens. Steri-strips or bandages will be used to close the incision site. No sutures will be required.

  • The patient will be monitored for at least two hours after the procedure in the recovery room.

What Are the Instructions After the Procedure?

  • After the procedure is complete, patients will have to lie down for the first hour, and then after an hour, they may sit up. After two hours, the patient may be mobilized and asked to walk.

  • The patient may find immediate pain relief at least within two days of the procedure.

  • However, they might be asked to rest for 24 to 48 hours.

  • Patients can return to their normal activities, although heavy strenuous physical activities should be restricted for six weeks.

  • No driving for two to three days.

  • No smoking and alcohol for two weeks after the procedure.

  • Do not bend or twist the back.

  • Initially, walk for five to ten minutes every three to four hours, and then gradually, it can be increased.

  • Blood thinners and other medications may be resumed with the doctor’s advice.

  • Certain medications and supplements may be suggested by the doctor to strengthen the bone and prevent any further fracture.

  • An ice pack may be used to relieve the soreness caused by the needle. Use it for 15 minutes hourly.

  • While taking a bath, ensure the bandage is kept dry for 48 hours after the procedure.

  • Ensure to dress the incision site.

When to Seek Medical Advice?

  • High temperature.

  • Uncontrolled pain.

  • Bleeding or discharge from the incision site.

  • Weakness in the extremities or the back.

  • Difficulty while passing urine or while bowel movement.

  • Difficulty in breathing.

What Are the Benefits of This Procedure?

  • Greatly improves patient’s functional abilities.

  • Pain relief is obtained immediately or a few days after the procedure.

  • Better patient movement within 48 hours of this procedure.

  • Positive patient outcome.

  • Minimally invasive procedure.

  • Well tolerated by the patients.

What Are the Risks of This Procedure?

  • There are minimal chances of infection, bleeding, or the pain increases after the surgery.

  • Weakness or numbness is associated with nerve damage.

  • Leakage of the cement out of the site. Leakage is potentially harmful only when it enters the spinal canal or lung circulation. It can also cause cord compression if leaked into the spinal canal.

  • Allergic reaction to the medications used.

What Are the Limitations of This Procedure?

Kyphoplasty is contraindicated in the following conditions:

  • When the pain is associated with disc problems, arthritis, stenosis, or cord compression.

  • When the vertebral fracture is stable and not painful.

  • Infection of the bone such as osteomyelitis.

  • History of allergic disorder.

  • Not recommended in patients with severe lung disease as they might not be able to lie with their face down for an hour or two that kyphoplasty requires.

  • Healed fractures.

  • Not recommended in scoliosis or kyphosis caused by reasons other than osteoporosis.

  • Tumor in the spinal canal.

  • Ladies who might be pregnant.

  • Fractured bony fragment impinging the spinal canal.

What Is the Difference Between Vertebroplasty and Kyphoplasty?

Vertebroplasty and Kyphoplasty


Kyphoplasty is a safe and effective treatment procedure for vertebral compression fractures. Studies have proven that most fractures would heal by themselves with time, however, in a compromised manner. Hence it is advocated that kyphoplasty be conducted within the first few weeks (maximum by eight weeks) of the fracture for a successful outcome. Kyphoplasty provides immediate pain relief and improves the patient's mobility considerably, thereby improving their quality of life.

Frequently Asked Questions


What Is Kyphoplasty?

Kyphoplasty is a minimally invasive surgical procedure. This is generally done to treat painful compression fractures of the spine. Vertebral body compression fractures are small breaks in the thick mass of the bone that forms the front part of the spinal column (vertebral body). In vertebral body fractures, all or some parts of the spine collapse, causing the spine to shorten and curve, and kyphoplasty is done to correct this deformity.


Is Kyphoplasty a Major or Minor Surgery?

Kyphoplasty is considered a minimally invasive surgical procedure that can be done with the help of general or local anesthesia based on the situation. In this procedure, a small skin puncture or incision is made rather than a big one, and this procedure takes around one to two hours per vertebral level to complete.


What Are the Dangers of Kyphoplasty?

Kyphoplasty is a safe procedure and is a minimally invasive technique. The rate of complications is very low compared to other surgical procedures. However, there are some risks associated with kyphoplasty, which include bone cement leakage, which means the injected bone cement moves beyond the compression cracks or fractures. In addition to that infection, bleeding increases back pain or numbness, and a tingling sensation can also be seen.


What Is the Cost of Kyphoplasty?

Kyphoplasty is an expensive procedure and costs more than vertebroplasty. The average cost of this treatment in the US is $8,800 to $29,000, depending upon the location, and in India, it costs around rupees three to four lacs. The high cost of this procedure is due to additional expensive equipment, anesthesia, and hospital charges.


What Is the Success Rate of Kyphoplasty?

Complications are very rare in kyphoplasty procedures, and this procedure is not that invasive and requires small incisions on the body to examine the operated site. Kyphoplasty is a safe procedure, and the success rate of this procedure is around 96 percent. 


Who Needs Kyphoplasty?

Kyphoplasty procedure is usually reserved for people with painful increasing back pain that is caused by osteoporotic or pathological vertebral compression fractures. Patients with reduced ability to move and function are selected for this procedure. It is normally done in the case of vertebral fractures and can also be done in other conditions such as disk herniation, arthritis, or stenosis (narrowing).


Is Walking Good After Kyphoplasty?

Kyphoplasty is considered an outpatient procedure. Usually, in the majority of cases, patients can walk after a couple of hours. However, within the first day of the surgery, patients are instructed to rest and not to do any straining activity, such as lifting heavy objects.


Can Kyphoplasty Be Performed on Elderly Patients?

Percutaneous balloon kyphoplasty is another type of kyphoplasty that is a safe and effective procedure for the treatment of elderly patients. In this procedure, a specialized inflatable balloon is used to expand a collapsed vertebral body. After this surgery, the patient may feel soreness at the site of surgery, and it will get normal within a few weeks. The majority of the patients may be able to get back to their daily chores within a day or two.


In What All Cases Are Kyphoplasty Not Recommended?

Kyphoplasty is usually done in cases with vertebral fractures or compression cases, leading to pain and the inability of the patients to move. This condition is not a good choice for treating spinal deformities. Other than that, cases with bone infections, bleeding disorders, tumors in the spinal canal, and allergies to any medications used during the surgery.


Does a Neurosurgeon Perform Kyphoplasty?

Kyphoplasty can be performed by neurosurgeons along with other specialties doctors like orthopedic surgeons or interventional neuroradiologists. Neurosurgeons treat this condition with pain medication, medicines to stabilize bone density, reducing physical activity, and using braces to minimize motion during the healing process after surgery. 


What Is the Alternative Method to Kyphoplasty?

In people where kyphoplasty is not recommended, vesselplasty is the other method that can be done instead of kyphoplasty. Vesselplasty provides similar pain relief from vertebral compression but has very minimal chances of lower spinal canal leakage as compared to kyphoplasty. Therefore, this is considered a better option than kyphoplasty in patients with osteoporotic compression fractures with posterior wall rupture.


What Changes Can Be Noticed After Kyphoplasty?

- After kyphoplasty, patients are not able to walk or stand immediately and require some rest to perform these activities.
- Someone else has to drive the patient home from the hospital.
- The patient may be able to return to normal activities within a day or two but should avoid heavy lifting for at least a few weeks.
- The pain usually subsides within two or three days of the surgery.

Last reviewed at:
31 Jan 2023  -  6 min read




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