Vertebroplasty and kyphoplasty are minimally invasive forms of spine surgery used to repair compression fractures of vertebrae. They stabilize and strengthen fractured spinal bones, reducing a patient’s pain and increasing physical functioning.

A compression fracture occurs when weakened vertebrae break and collapse. This crushing of bone tissue causes the affected vertebrae to be shorter than others, and puts additional pressure on other vertebrae. When the front of the vertebrae collapse, the spine shortens and falls forward. The vertebrae in the chest area and lower spine tend to be most affected by compression fractures.

Vertebral compression fractures usually result from the loss of bone mass and density due to osteoporosis. As osteoporosis progresses, the weight of the head, neck and chest may be enough to cause the bones in the back to fracture during daily activities, such as getting out of a car or turning over in bed. According to the National Osteoporosis Foundation, the disease causes 700,000 vertebral fractures each year in the United States. Other possible causes of vertebral compression fractures include tumors and physical trauma to the spine.

Vertebral compression fractures can have varying signs and symptoms. A patient may experience acute back pain. The pain is likely to be worse when standing due to added pressure on the vertebrae. In addition, touching the area can cause pain. Other possible indicators of vertebral fractures include limited mobility, a reduction in the patient’s height, stooped posture, kyphosis (exaggerated forward curve in the upper back) and reduced breathing capability. If the vertebral compression fracture puts pressure on the nerves, it may also cause leg pain. Pressure on the lungs can cause breathing problems.

Many vertebral compression fractures eventually heal themselves. In cases where a patient’s pain is severe or does not respond to noninvasive techniques (e.g., bed rest, back brace, analgesics), a vertebroplasty or kyphoplasty may be recommended. The use of opioid pain relievers may be discouraged for older patients, as this may increase the risk of accidental falls and more bone fractures.

Vertebroplasty was developed and first used in the early 1980s. In this procedure, a special cement-like material is injected into a collapsed vertebra. The cement fills hollow spaces and cracks in the bone and solidifies the pieces into one hard structure. The cement used in a vertebroplasty is generally less dense (more runny) than that used in kyphoplasty. This allows easier diffusion of the material, allowing it to get into all areas around the crushed bones. The cement essential forms an internal cast, stabilizing fractured bones.

Kyphoplasty is similar, but before the cement is injected, a balloon-like device is introduced into the area and inflated within the damaged vertebra. This helps to restore the height of the damaged vertebra. How much height can be restored may depend on the age of the fracture. The balloon is then removed and the cavity is filled with the cement. The advantage of kyphoplasty over vertebroplasty is that it can restore vertebral height, helping a patient to regain lost height and/or lessen spinal deformity due to the compression fracture.

Vertebroplasty is often recommended for patients with vertebral compression fractures who are experiencing pain that is not responsive to conservative treatment methods. Kyphoplasty is usually reserved for patients who also have spinal deformities such as a significantly stooped posture or kyphosis.

These procedures are designed to treat compression fractures of the spine. They do not help other spinal conditions that can cause back pain, such as herniated discs or severe arthritis. In addition, neither procedure is recommended for patients with active infections or blood-clotting disorders. Patients with fractures that have already healed are unlikely to benefit from these procedures. 

In addition, timing of treatment is important. Vertebroplasty and kyphoplasty appear to be most effective within three months of the fracture (when a patient’s symptoms began).

Vertebroplasty and kyphoplasty are typically performed as outpatient procedures. The procedure can take about an hour for each vertebra repaired. Multiple vertebral fractures may be repaired in a single visit.

Some people treated with vertebroplasty or kyphoplasty experience complete or significant pain relief and are able to return to activities they enjoyed prior to the fracture.