Compression Fracture of Vertebral Body
Compression Fracture of a Vertebral Body (Kyphoplasty/ Vertebroplasty)| Vascular Neurology of Southern California
A compression fracture or a break of a vertebra can be limiting because it makes movement difficult or painful when bone fragments rub against each other.
Broken vertebrae are often caused by bones collapsing, known as a compression fracture, a condition more likely found in individuals with osteoporosis. Though not every patient who has broken vertebrae is a candidate, many patients can benefit from the fracture’s surgical repair using kyphoplasty or vertebroplasty. These minimally invasive procedures are often performed together and may be completed without general anesthesia or even a hospital stay.
Dr. M. Asif Taqi is a quintuple-board-certified neurointerventionalist with many years of experience treating spinal damage. He has extensive expertise in neurology, vascular interventions, critical care neurology, neuroendovascular surgery. His advanced skills and caring manner make him one of Southern California’s most sought-after physicians.
Kyphoplasty may be employed to repair broken vertebrae. In summary, a surgical balloon is inserted past the skin and muscle and into a precise location in the target bone using a specialized needle. The balloon is inflated to make room for a cement mixture that repairs the fracture and provides support for the spine. After the cement is injected, the balloon is removed.
Also known as balloon vertebroplasty, this procedure is best performed within a month or two of the initial fracture diagnosis. Many patients experience improved mobility through kyphoplasty, and the procedure often relieves pain when other options have been exhausted.
Candidates for Kyphoplasty or Vertebroplasty
Candidates for these procedures often have had reduced movement and function because of recent vertebral compression fractures.
When this type of fracture cannot heal naturally, with the help of a brace or other traditional treatments, vertebroplasty and kyphoplasty may be performed. These procedures are typically performed on patients over 65 and whose bones have become weakened by cancer or suffer from vertebrae that collapse with painful complications due to osteoporosis.
To be a good candidate, a patient’s pain must be related to the vertebral fracture, not other problems such as disk herniation, arthritis, or a curvature of the spine due to scoliosis or stenosis (narrowing). Imaging tests—such as spinal X-rays, bone scans, and computed tomography (CT) or magnetic resonance imaging (MRI) scans—might be requested to confirm the presence of a vertebral fracture.
What Happens Before and During the Procedures
Vertebroplasty is performed under mild sedation where Dr. Taqi precisely places a catheter inside the fracture. A bone cement solution is injected into the fractured vertebra under pressure and left to dry. Once it has dried, the cement hardens to join the bone fragments together and provide stability. The goal of the procedure is to stabilize the fractured bone to create pain relief and improve the ability to move.
Kyphoplasty is conducted under general or local anesthesia. During the first step in the process, Dr. Taqi places a balloon catheter inside the broken vertebra. A liquid is pumped under pressure into the balloon, expanding it to correct displacement of bone fragments in the ruptured vertebrae and create space for the substance that will repair the collapsed bone.
After the balloon reaches the maximum inflation, it creates a cavity that is filled with cement that hardens, providing firmness to the bones and reestablishing structure that will improve sensation and mobility.
Preparation for Surgery
Because kyphoplasty and vertebroplasty are surgical procedures that require the assessment of your overall health status, Dr. Taqi may order blood tests before your surgery. Imaging tests such as an X-ray or MRI scan will help him become more familiar with the area or areas that need repair.
As part of the preparation, an intravenous line (IV) will be placed into a vein in your arm to deliver anesthesia. Pain and anti-nausea medications may also be administered, as well as antibiotics, to prevent infection.
The Procedures in Detail
For these procedures, you need to be lying on your stomach. After the treatment area is shaved, cleaned, and sterilized, a local anesthetic may be injected.
Dr. Taqi will then perform these steps:
- A small incision is made in the back through which Dr. Taqi will insert a hollow needle (trocar) into your skin.
- With the aid of fluoroscopic X-ray, the trocar is guided into the designated position in your bone.
- Using the X-ray images, Dr. Taqi inserts a special balloon through the trocar and into the vertebra, where it is gently inflated. As the balloon inflates, it elevates the fracture, returning the pieces to a more stable position. At the same time, it also compacts the soft inner bone to create a cavity or space inside the vertebra to be filled with bone cement.
- The cement mixture then is injected to fill the space. Imaging tests help Dr. Taqi confirm that the mixture is distributed correctly.
- Once the cement is in place, the needle will be removed, the area bandaged, the IV, and the monitoring equipment removed. Generally, stitches are not necessary for kyphoplasty.
If only one vertebra is being treated, the entire procedure usually takes less than an hour. Many of Dr. Taqi’s patients return home on the same day as their surgery. To do this, you will need someone to drive you home and monitor your progress there, staying with you for at least the first 24 hours after your procedure.
Recovery After the Procedure
Most patients can return home on the same day as their kyphoplasty. However, those who have kyphoplasty performed on more than one vertebra or who experienced complications during the surgery may need to stay overnight. Patients who are in poor general health may be required to stay overnight for observation after kyphoplasty.
Within an hour of the procedure, you may be encouraged to get up and walk. Some soreness and discomfort can initially be expected, but pain medication will be available to ensure your comfort. Ice packs can help relieve immediate soreness or pain, and you should be feeling better within 48 hours.
For your recovery, Dr. Taqi will give you a set of instructions to follow. You must adhere to these recommendations to support your healing and maximize the procedure’s results. Dr. Taqi will let you know when it is safe to resume normal physical activities, but you can expect to rest and take things easy for at least the first two days after your kyphoplasty.
Dr. Taqi will advise you as to when you can resume normal activities and if you should take any bone-strengthening supplements or medications. You will probably be asked to schedule a follow-up visit to check your progress.
Complications and Risks
All medical procedures carry some level of risk. For example, there is a small chance of infection or bleeding from the site where the needle was inserted through your skin. In some cases, nerve damage can lead to weakness, numbness, or tingling, and it is possible to have an allergic reaction to materials used in the procedure.
Your Next Steps
If you or your loved one suffer from back pain and reduced mobility due to compression fracture of one or more vertebrae, then seek treatment from Southern California’s leading neurointerventionalist, Dr. M. Asif Taqi. Contact or call us at (805) 242-4884 to schedule your appointment today.