How does kyphoplasty work?

Kyphoplasty is the stabilisation of vertebral body fractures by introducing bone cement, whereby the original shape of the vertebral body has been previously restored with a balloon.

The balloon is introduced to the collapsed vertebral body and filled with liquid contrast agent. Then bone cement is injected, stabilising the collapsed vertebral body from inside and preventing any further painful deformation.Patients usually feel considerable pain relief directly after the operation. Kyphoplasty ranks among the minimally invasive surgery so patients only have to remain in hospital for a few days.

The operation is usually performed under a general anaesthetic. In some cases it can also be conducted under a local anaesthetic. The method of anaesthesia to be used is discussed with the surgeon or the anaesthetist when they brief you about informed consent.

The operation to treat a vertebral body fracture usually takes about 45 minutes; if more than one vertebral body is being treated, surgery will take 20 minutes longer for each one.

When under anaesthetic, the patient is placed on his stomach. Then the vertebral body or bodies involved are marked on the patient's back and covered with sterile drapes. An X-ray unit or CT scanner is placed at the ready so that the surgeon can check the position and direction of his surgical instruments during the operation. Finally the surgeon makes small skin incisions about 1 cm long on the left and right of the vertebral body involved.

Now a needle is introduced through each of these skin incisions and inserted into the vertebral body. Using the X-ray unit or CT scanner the surgeon checks at any time to make sure the hollow needles are in the ideal position. Once the hollow needles are positioned correctly they are now replaced with working channels.

The surgeon now introduces balloons to the vertebral body via the working channels. These are then filled with liquid contrast agent so that the surgeon can check on the X-ray unit or CT scanner how the original shape of the vertebral body is being restored. Once he has reached sufficient height, the balloons containing the contrast agent are removed.

Viscous bone cement is introduced to the created voids via the working channels. This creates a kind of "inner cast" for the vertebral body. It also contains a contrast agent so the surgeon can closely monitor and evaluate the distribution of bone cement on the X-ray unit or CT scanner.

When sufficient bone cement has been injected into the vertebral body, the working channels can be removed. Then the small skin incisions are closed either with skin sutures or plasters.

If a general anaesthetic was administered, the patient is monitored and looked after by a specially trained nursing team and anaesthetists in the recovery room immediately after the operation. If necessary, infusions or pain killers are administered. Once the patient's general condition has stabilised, he or she is transferred to his or her room on the normal ward.