Kyphoplasty for Spinal Compression Fractures: What Patients Should Know

Spinal compression fractures can cause sudden or persistent back pain, limit mobility, and make everyday activities difficult. These fractures are particularly common in older adults with osteoporosis, but they can also result from falls, accidents, or other injuries.

For patients whose pain does not improve with conservative treatment, kyphoplasty may offer a minimally invasive treatment option. But what exactly is kyphoplasty, who is a candidate, and what can patients expect from the procedure?

What Is a Spinal Compression Fracture?

A spinal compression fracture occurs when one of the vertebrae in the spine collapses or becomes compressed. These fractures most commonly affect the thoracic and lumbar spine and can cause significant pain, particularly with standing, walking, bending, or changing positions.

Osteoporosis is one of the leading causes because weakened bones are more vulnerable to fracture. However, compression fractures can also occur after trauma or when a tumor weakens the vertebra.

A compression fracture can sometimes develop without a major injury. In people with osteoporosis, something as routine as lifting an object, coughing, or twisting may contribute to a fracture.

What Symptoms Can a Spinal Compression Fracture Cause?

Symptoms of a spinal compression fracture can include sudden or gradually developing back pain, tenderness over the affected vertebra, difficulty standing upright, and reduced mobility.

Some patients experience pain that becomes worse when standing or walking and improves when lying down. Multiple compression fractures can also change the shape of the spine, sometimes creating an exaggerated forward curvature known as kyphosis.

Because similar symptoms can occur with other spinal conditions, imaging is generally needed to determine whether a compression fracture is responsible for the pain.

How Is a Spinal Compression Fracture Diagnosed?

Doctors may use X-rays, MRI scans, CT scans, or other imaging studies to evaluate a suspected compression fracture.

Imaging can help determine whether a vertebra has collapsed and whether the fracture appears recent or older. MRI can be particularly useful when doctors need to determine whether a fracture is active and potentially responsible for current pain.

A medical evaluation is important because not every compression fracture requires a procedure such as kyphoplasty.

What Is Kyphoplasty?

Kyphoplasty is a minimally invasive procedure designed to stabilize certain painful spinal compression fractures.

During kyphoplasty, a physician typically uses imaging guidance to insert a small instrument through a needle into the fractured vertebra. A balloon may then be carefully inflated inside the vertebral body to create a cavity and potentially restore some vertebral height. The balloon is removed, and bone cement is injected into the space to stabilize the fracture.

The procedure is generally performed through a small skin opening rather than through traditional open spine surgery.

How Does Kyphoplasty Help With Compression Fracture Pain?

Kyphoplasty can help stabilize a fractured vertebra, which may reduce the mechanical pain associated with movement of the damaged bone.

The procedure may also help restore some vertebral body height in appropriately selected patients. By stabilizing the fracture and potentially improving spinal alignment, kyphoplasty may make it easier for patients to stand, walk, and return to normal activities.

The degree of pain relief varies from patient to patient, and kyphoplasty is not appropriate for every type of back pain.

Who May Be a Candidate for Kyphoplasty?

Patients with a painful spinal compression fracture that has not adequately improved with conservative care may be considered for kyphoplasty.

Candidates are typically evaluated based on their symptoms, imaging findings, overall health, the age and location of the fracture, and whether the fracture appears to be responsible for the pain.

Patients with osteoporosis may also need evaluation and treatment for their underlying bone loss. Stabilizing one fracture does not eliminate the risk of future fractures.

Is Kyphoplasty a Form of Spine Surgery?

Kyphoplasty is considered a minimally invasive spinal procedure, but it differs significantly from traditional open spine surgery.

Rather than making a large incision or removing portions of the spine, kyphoplasty is performed through a small access point in the skin using imaging guidance. This can mean less disruption to surrounding tissues and a shorter recovery compared with many conventional surgical procedures.

However, as with any medical procedure, kyphoplasty has potential risks and should be recommended only after an appropriate evaluation.

What Happens During a Kyphoplasty Procedure?

During kyphoplasty, the patient is positioned so the physician can access the affected vertebra. Imaging is used throughout the procedure to guide the instruments accurately.

A small needle is placed into the fractured vertebra. A balloon may be inserted and inflated before being removed. Bone cement is then introduced into the vertebral body to stabilize the fracture.

The procedure itself is typically relatively short, although the exact length depends on factors such as the number of vertebrae being treated and the patient’s individual circumstances.

What Is Recovery Like After Kyphoplasty?

Recovery after kyphoplasty is often shorter than recovery from traditional open spinal surgery. Some patients experience significant pain relief soon after the procedure, although recovery varies depending on the severity and duration of the fracture and the patient’s overall health.

Patients may be given specific instructions regarding physical activity, lifting, bending, and returning to normal activities. Following these instructions can help support a safe recovery.

Persistent or worsening pain after the procedure should be evaluated by a medical professional.

What Are the Risks of Kyphoplasty?

Although kyphoplasty is minimally invasive, it is not risk-free. Potential complications can include infection, bleeding, nerve irritation or injury, allergic reactions, and leakage of bone cement outside the vertebral body.

The risk of complications varies based on the patient’s health, anatomy, the location of the fracture, and other factors. A physician should explain the potential benefits and risks before treatment.

Can Kyphoplasty Prevent Future Compression Fractures?

Kyphoplasty treats and stabilizes a specific fractured vertebra, but it does not cure osteoporosis or eliminate the risk of future fractures.

Patients with osteoporosis should discuss bone health with their healthcare provider. Addressing bone density, fall risk, physical activity, nutrition, and other contributing factors may be an important part of preventing additional spinal fractures.

When Should Patients Consider Kyphoplasty for a Compression Fracture?

Patients with persistent or severe pain from a confirmed spinal compression fracture may benefit from discussing kyphoplasty with a spine or pain specialist, particularly when conservative treatment has not provided sufficient relief.

The decision should be based on the patient’s symptoms, imaging results, overall health, and the characteristics of the fracture. A thorough evaluation can help determine whether kyphoplasty or another treatment is appropriate.

The Bottom Line

Kyphoplasty for spinal compression fractures is a minimally invasive procedure that can stabilize certain painful vertebral fractures and potentially improve mobility and quality of life. For appropriately selected patients, it may provide an alternative to prolonged conservative treatment or more extensive spine surgery.

Because compression fractures can have multiple causes, an accurate diagnosis is an important first step. Patients experiencing new or persistent back pain, particularly after a fall or with known osteoporosis, should seek medical evaluation to determine the underlying cause.

This article is for educational purposes only and is not a substitute for individualized medical advice, diagnosis, or treatment.