Minimally Invasive Treatment of Vertebral Compression Fractures: Vertebral Augmentation Implant, Kyphoplasty, Vertebroplasty

Written by Isador H. Lieberman, MD, MBA, FRCSC

Spinal compression fractures may be treated with surgery. Vertebral Augmentation Implant, Kyphoplasty, and Vertebroplasty are three minimally invasive treatments for thoracic and lumbar spinal compression fractures. These procedures use bone cement.

Vertebral Augmentation Implant
A newer type of vertebral augmentation system is now performed that is different from vertebroplasty and kyphoplasty. This minimally invasive treatment for thoracic and lumbar spinal compression fractures utilizes a continuous loop-like spinal implant. Like other procedures, it is performed using image-guidance. During the percutaneous (through the skin) procedure, the implant is delivered through a small, single incision. After the implant is in place, bone cement is injected and the implant is removed.

During kyphoplasty, also called balloon kyphoplasty, a thin tube is inserted into the collapsed vertebra. Attached to the tube is a small balloon that, when inflated, moves the broken bone creating a space. The balloon is removed and the space is filled with thick liquid bone cement. Balloon kyphoplasty can relieve pain and stabilizes the compression spinal fracture. In addition, kyphoplasty may also restore vertebral height thus reducing spinal deformity.

During vertebroplasty, the cement is injected into the collapsed vertebrae. The bone cement rapidly hardens and stabilizes the fracture. Vertebroplasty can help to relieve pain and may strengthen other vertebrae that are weak but not fractured.

Vertebral Augmentation Implant, Kyphoplasty and Vertebroplasty
These procedures may decrease or eliminate pain associated with a thoracic or lumbar vertebral compression fracture. With kyphoplasty or vertebroplasty, there is a risk of bone cement migrating out of place (called extravasation). As with any surgical procedure, there are risks such as infection.Your interventional physician or surgeon will explain each procedure's benefits and risks.

Spinal Fusion
Sometimes a vertebral compression fracture does not heal. In such a case, your spine surgeon may recommend a procedure that include spinal fusion. Spinal fusion joins two or more vertebrae together. The surgical procedure may include instrumentation (eg, screws, rods, interbody devices) and bone graft. Once again, your spine surgeon will explain the procedure as well as the benefit and risks.

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