Kyphoplasty: A New Treatment for Osteoporotic Vertebral Compression Fractures

Kyphoplasty involves extra- or transpedicular cannulation of the vertebral body under fluoroscopic guidance, followed by insertion of an inflatable bone tamp (Figure 2).

Once inflated, the tamp restores the vertebral body toward its original height, while creating a cavity to be filled with bone cement. Cement is injected under relatively low pressure (see Figures 3 through 6 below).

Vertebroplasty, from which the kyphoplasty technique evolved, was developed in response to limited results of medical and surgical modalities to stabilize and strengthen collapsed vertebral bodies. Interventional neuroradiologists, first in France and then in the United States, began transpedicular percutaneous bone cement injections in 1986. Vertebroplasty offers significant benefits: reduced or eliminated fracture pain, prevention of further collapse, a rapid return to mobility and prevention of bone loss caused by bed rest. However, it does not address spinal deformity. It also requires high-pressure cement injection using low-viscosity cement, which leads to cement leaks in 30-80% of procedures, according to recent studies.

Kyphoplasty has several potential advantages over vertebroplasty. It restores vertebral body height with a low risk of cement extravasation. Kyphoplasty is well tolerated and is associated with statistically significant improvements in pain and function.