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Kyphoplasty Kyphoplasty is a minimally invasive spinal surgery procedure used to treat painful progressive vertebral body collapse/fracture (VCFs) due to osteoporosis or tumor spread to the vertebral body. Osteoporosis, or the age related softening of bones, causes the building blocks of the spine to weaken and collapse. This results in severe pain and a progressive hunchback. Certain forms of cancer also weaken the bone and cause the same problems. Kyphoplasty is not appropriate for patients with young healthy bone or who have been involved in a major accident and sustained a vertebral body fracture or collapse. Nor is it appropriate for patients with spinal curvature such as scoliosis or kyphosis that is due to causes other than osteoporosis. Likewise kyphoplasty is not appropriate for patients who suffer from spinal stenosis or herniated discs with nerve or spinal cord compression and loss of neurological function not associated with a vertebral compression fracture. The kyphoplasty procedure involves the use of a balloon to restore the vertebral body height and shape followed by bone cement to strengthen it. The procedure may be performed under intravenous sedation with local anesthetic or under general anesthetic. The patient lies face-down on the operating room table. Two x-ray machines are used to visualize the collapsed bones. The surgeon makes two small (less than 3mm) incisions and inserts a tube into the center of the vertebral body. Through this tube balloons are placed in the center of the vertebral body. The balloons are then inflated to push the bone back towards its normal height and shape. This also helps create a cavity, which the surgeon will fill with the bone cement. Once the cavity is created, the surgeon removes the inflatable balloon bone tamp, mixes the cement and fills the cavity in a slow, controlled fashion. After the cement hardens, the surgeon removes the tubes and closes the incisions with a single stitch. Patients typically go home the same day. Patients can resume all normal activities of daily living as soon as possible with no restrictions. Early results indicate that kyphoplasty is a safe, effective method of vertebral reconstruction and stabilization in the treatment of osteoporotic VCFs. As with any surgical procedure, kyphoplasty does have risks. These complications may require additional treatments in the form of medications or surgery. Kyphoplasty is associated with excellent pain relief due to the vertebral body collapse. Well over 95 percent of patients rate their treatment a success and are able to return to all their pre-VCF function. Patients typically do not need any form of physical therapy or rehabilitation after a kyphoplasty procedure. Because bone cement hardens within 15 minutes there is really no healing from the patient’s standpoint that needs to occur. Occasionally, patients complain of persistent pain after kyphoplasty. This may be due to irritation of local tissues during the procedure itself. However, it is more likely due to the underlying arthritic and degenerative changes in the spine. If the persistent pain is due to the procedure, it will typically diminish within two weeks. If the pain is due to the arthritic degenerative changes in the spine, the usual treatment consists of medications and an ongoing exercise program. Restoration of vertebral body height and size is best when kyphoplasty is performed soon after the VCFs occur. After kyphoplasty, some patients may develop other fractures at other levels due to severe osteoporosis. All patients must be on bone-strengthening medications during treatment, but if further collapse occurs, kyphoplasty can be used at those other levels as well. Kyphoplasty does have a tendency to help prevent further fractures by keeping the spine aligned in its native upright position. The usual risks of local or general anesthetics apply and depend on the patient’s overall health. There is a small risk of the bone cement leaking from within the boundaries of the vertebral body. In most cases this rare event (occurrence less than 10%) does not cause any problems. In very rare circumstances the cement may irritate or damage the spinal cord or nerves causing pain, altered sensation, or even, very rarely, paralysis (estimated risk is less than 1 in 10,000). Should the cement leak further, more significant surgery may be required to relieve the irritation of the nerves or spinal cord. There also exists a very small chance of the cement traveling to lungs and an even smaller chance of the cement block becoming infected at the time of surgery or even years after surgery.