PROCEDURE: Â Â kyphoplastyÂ
CLINICAL INDICATION: Back pain with diminished ability to ambulate. Patient presents for kyphoplasty for pain relief. MRI shows subacute compression fracture at  .
OPERATORS:Â
MEDICATIONS: Per nursing flow sheet.
COMPLICATIONS: None immediately
PROCEDURE: Following informed written consent, the patient was placed in the prone position on the interventional radiology table. The patient’s lower back was prepped and draped in the usual sterile fashion. Using fluoroscopic guidance, a Striker kyphoplasty access needle was placed using a transpedicular approach through the left ____ pedicle. The needle tip was advanced to the posterior third of the vertebral body, with special attention such that the medial aspect of the pedicle was not transgressed. Using a similar approach, a second access needle was placed from a right   approach to the posterior third of the   vertebral body. The drill was then advanced to the anterior one-third of the vertebral body on each side.
The kyphoplasty balloons were inserted into each cannula under fluoroscopic guidance and inflated with care. The cement was mixed, and kyphoplasty balloons removed after being deflated. The cement was injected under fluoroscopy at the   level through the access needles. Cement injection was stopped once there was adequate fill of the vertebral body. The cannulas were removed carefully under fluoroscopic guidance. Hemostasis was achieved with light manual compression. The patient tolerated the procedure well. The patient was then sent from the interventional radiology suite to the post procedural care area for recovery.
FINDINGS: Compression fracture at the ____vertebral level with approximately ___loss of central vertebral body height. Post kyphoplasty image demonstrates cement appropriately within the____vertebral level with slight restoration of height.
IMPRESSION: Successful ___ fluoroscopic guided kyphoplasty.Â
Frequently Asked Questions
Kyphoplasty is a minimally invasive surgical procedure used to treat compression fractures in the spine, often caused by osteoporosis. It involves inserting a balloon into the fractured vertebra and inflating it to create space. This space is then filled with bone cement to stabilize the fracture and relieve pain. The procedure helps restore vertebral height and alignment, which can improve mobility and reduce pain.
During kyphoplasty, the patient is placed in a prone position and the back is prepped in a sterile fashion. Using fluoroscopic guidance, a needle is inserted into the vertebra through a transpedicular approach. A balloon is inflated to create a cavity in the vertebra, which is then filled with cement. This stabilizes the fracture and restores some of the lost vertebral height. The procedure is typically completed within an hour.
What are the risks or complications associated with kyphoplasty?
Kyphoplasty is generally safe, but like any procedure, it carries risks. Potential complications include infection, bleeding, cement leakage, and nerve damage. However, these are rare, and most patients experience significant pain relief and improved mobility after the procedure. It's important for patients to discuss their medical history with their doctor to minimize risks.
How does kyphoplasty differ from vertebroplasty?
Both kyphoplasty and vertebroplasty aim to treat spinal compression fractures. The key difference is that kyphoplasty uses a balloon to create a space within the vertebra before injecting cement, allowing for some restoration of vertebral height. Vertebroplasty involves injecting cement directly into the fractured bone without prior cavity creation. Kyphoplasty may be preferred for fractures with more significant collapse.
What can patients expect during recovery from kyphoplasty?
Recovery from kyphoplasty is generally quick. Patients can often return home the same day, with some experiencing immediate pain relief. It's recommended to avoid strenuous activities for a few weeks. Patients should follow their doctor's advice on activity levels and any prescribed medications. Follow-up appointments are important to monitor healing and address any questions or concerns.
Who is a good candidate for kyphoplasty?
Ideal candidates for kyphoplasty are those with osteoporotic compression fractures that cause significant pain and mobility issues. It's also suitable for patients with fractures due to cancer or trauma, as long as they are medically stable. A thorough medical evaluation, including imaging studies like MRI, helps determine if kyphoplasty is appropriate for a patient.
What imaging techniques are used during kyphoplasty?
Fluoroscopy is the primary imaging technique used during kyphoplasty. It provides real-time X-ray images, helping the surgeon guide needles, balloons, and cement with precision. This ensures accurate placement and minimizes the risk of complications. MRI may be used preoperatively to assess the fracture and plan the procedure.
How long does a kyphoplasty procedure take?
A kyphoplasty procedure typically takes about one to two hours, depending on the number of vertebrae being treated and the complexity of the fractures. The procedure is minimally invasive, allowing for a relatively short duration compared to open surgeries. Most patients can return home the same day after a short recovery period.