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Kyphoplasty

This procedure is performed to relieve pain in those patients who have compression fractures. Other means of conservative care such as medications and bracing and activity modification are recommended. If they fail then this procedure is indicated. MRI scan on STIR image shows "white" signal showing boney edema indicating that fracture is most likely relatively recent and cause of the pain. At times bone scan is also used in addition to confirm the fact that the fractured vertebra is new rather than old. Old healed compression fractures would not cause pain.

The procedure is done under general anesthesia. Two C arms or X ray machines are used. Large needles are inserted into the vertebral bodies using x ray control through the bony structure called pedicles. Then deflated balloon is inserted into the collapsed vertebral body. The balloon is then inflated restoring some height of the collapsed vertebra and making room for cement to be injected later. The balloon is then deflated and cement is injected into the cavity created by balloon deflation under LOW PRESSURE. This low pressure injection into the cavity that is already there makes this procedure much safer than vertebroplasty as far as leakage of cement into undesirable locations such as nerve roots or spinal cord. Leakage of cement onto neural structures can cause paralysis or permanent nerve damage.

The procedure takes about half an hour. The pain relief is usually immediate and thought to be related to the destruction of nerve endings in the fractured bone by heat generated by cement as it sets and also related to the structural stability provided by the cement.

Risks of the procedure include paralysis, nerve injury, wound infection, allergic reactions, and risk of general anesthesia.

Only patients who are in severe pain and cannot cope with conservative measures such as pain medications, bracing, and activity modifications should undergo this procedure.

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