Osteoporosis affects around 10 million people in the United States and is a common cause of fractures, including in the spine.
There are several treatments available to treat spinal issues, including kyphoplasty and vertebroplasty procedures. Keep reading to find out more about how they can help and ways to maximize their benefit post-recovery.
The most common cause of compression fractures is osteoporosis. Other causes include spine injuries (from accidents or sports injuries) and tumors in the spine. However, preventing and treating osteoporosis is the best way to decrease the risk of compression fractures. Women are generally at higher risk of developing osteoporosis, especially after menopause, but it can affect older men as well.
Additionally, people who have experienced one compression fracture due to osteoporosis have a much higher risk of having another one.
The most common osteoporosis fractures occur in the spine. Spinal fractures, also called vertebral compression fractures, are nearly twice as common as other fractures, such as those occurring in the wrist or hip. Vertebral compression fractures are small breaks in the vertebra, and can cause your spine to shorten and curve forward. Kyphoplasty and vertebroplasty procedures, however, can help treat these breaks.
Kyphoplasty and vertebroplasty procedures are designed to reduce or eliminate pain caused by the fractured bone, as well as to stabilize the bone and restore lost vertebral height. However, treatment of the underlying osteoporosis is an important part of the kyphoplasty/vertebroplasty treatment plan, in order to reduce the chances of future fractures.
Osteoporosis treatment usually includes calcium supplements, vitamin D, weight-bearing exercises, and hormone replacement therapy for women.
Kyphoplasty and vertebroplasty are procedures that treat vertebral body compression fractures, which are breaks in the front part of the spinal column, otherwise known as the vertebral body. The vertebral body is a thick mass of bone, but osteoporosis can significantly reduce its bone mass, leading to breaks. These fractures can cause the compression or collapse of a vertebra, resulting in pain or a kyphotic deformity.
Vertebroplasty involves injecting a bone cement mixture into the fractured bone, while kyphoplasty inserts a balloon into the fractured bone first in order to create a space before filling it in with the mixture. Kyphoplasty/vertebroplasty is a pain treatment for vertebral compression fractures that don’t respond to conventional methods, and can also prevent further collapse of the vertebra.
Kyphoplasty/Vertebroplasty is usually performed by an interventional radiologist. They will first evaluate your condition using either a physical exam or diagnostic imaging. These treatments are minimally invasive and non-surgical, so they are usually outpatient procedures.
The interventional radiologist will use continuous x-ray imaging guidance (fluoroscopy) to insert a needle through the skin in the back into the damaged vertebra. They will then inject the medical-grade bone cement into the fractured bone. In the case of kyphoplasty, they will insert a balloon through the needle to create a cavity. The cement will be injected after the balloon is removed.
The entire procedure can be completed in one to two hours, depending on how many bones need the treatment. In comparison to other procedures that treat spinal compression fractures, like spinal fusion surgery, vertebroplasty and kyphoplasty have a much faster recovery time.
After a kyphoplasty/vertebroplasty, you will be transferred to a recovery room for one or two hours so the doctor can monitor your condition while the anesthesia wears off. While in the recovery room, the level of pain relief will be assessed to determine the level of success of the procedure. For many patients, pain relief is immediate, and for others, it may take a couple of days. Any pain resulting from the procedure will diminish within two to three days.
You should be able to walk roughly one hour after the treatment, but it is advised that you do not drive after the procedure. For the first 24 hours after a kyphoplasty/vertebroplasty, it is recommended to remain on bed rest or to take it easy. Once home, you can slowly increase your level of activity and resume your usual medication. However, any strenuous activity, especially heavy lifting, should be avoided for at least six weeks.
You may feel some soreness at the point of needle insertion for which you may use an ice pack, but ensure to protect your skin with a cloth and avoid getting your bandage wet.
Your doctor will typically schedule a follow-up appointment a couple of weeks after surgery to ensure a smooth recovery.
However, contact your doctor if you experience any of the following:
● A fever higher than 100 degrees Fahrenheit.
● Signs of infection at the incision, such as redness, swelling, pain, or drainage.
● Difficulty walking.
● Loss of balance.
● Issues with bowel or bladder function.
● Increased back pain.
If you experience any chest pain or shortness of breath, contact emergency services immediately.
Kyphoplasty/vertebroplasty has several benefits—it is non-invasive, less painful, requires a shorter hospital stay, and offers quick results. However, it still requires patients to take certain precautions post-treatment. Patients may be required to:
● Take any medication as directed.
● Wear a back brace, if instructed.
● Keep their bandage on for at least 24 hours.
● Do not do any heavy lifting for a minimum of six weeks.
● Walking and bending are encouraged, however, if you wear a back brace, they should only be done within the restrictions of the brace.
● Do not soak in a bathtub as long as your bandage is on to avoid infection. It is recommended to keep it completely dry for 24 hours.
● If a follow-up appointment is not scheduled, schedule a return visit approximately 6 weeks after the procedure.
● Do not drive for a few days following the procedure.
● Avoid sitting upright for over 30 minutes at a time.
● Roll on your side before getting out of bed.
● Note any signs of fever, redness, chills, or drainage from the incision. A slight amount of drainage is normal for a day or two following the treatment.
An important part of kyphoplasty/vertebroplasty recovery is to resume normal activities when your body feels ready. Part of this involves practicing stretching and strengthening exercises to help provide support for the spine. Your healthcare provider may recommend pre and post-operative physical therapy for this purpose. Research shows that physical therapy plays an important role when it comes to maximizing the positive effects of a kyphoplasty/vertebroplasty.
Some simple exercises can help patients reduce pain and discomfort while strengthening the spine. However, make sure to speak to your healthcare provider before engaging in any exercise to avoid injury. If you feel any pain while performing the exercises, stop and consult your healthcare provider.
1. Deep Abdominals
The deep muscles in the abdomen and pelvis are crucial to keep your spine stable.
● Lie on your back with a neutral spine and your knees bent. Keep your feet flat on the bed.
● Place your fingertips just above your pelvis.
● Slowly tighten your stomach muscles as if you are trying to pull your belly button towards your spine. Keep your upper body relaxed and breathe gently throughout the exercise.
● Hold each contraction for five seconds and repeat ten times.
2. Diaphragmatic Breathing
The diaphragm helps to stabilize your lower spine, and also helps with pain control.
● Start in a comfortable position, with a neutral spine (sitting, standing, or lying down).
● Place your hand on your stomach, over your lower ribs.
● Breathe in deeply, hold your breath, and slowly release for two seconds each. You can increase the number of seconds as you get more comfortable doing the exercise.
Walking is one of the most important things you can do to aid your recovery. When walking, ensure to maintain a good posture to prevent pain and discomfort.
● Wear proper clothing and footwear.
● Start with short walks on level ground. Use walking aids if necessary.
● Slowly increase the time you spend walking each day.
Georgia Vascular Institute provides comprehensive care and relief for a variety of conditions with one goal—to help you live life to the fullest. If you or a loved one are experiencing pain that gets in the way of your lifestyle, know that there are options available. The multidisciplinary team at Georgia Vascular Institute can help, so call us at (770) 506-4007 or schedule an appointment today to get started.