Balloon Kyphoplasty Helpful for Painful Vertebral Fractures
Vertebral (back) fractures can be very painful. It is estimated that approximately 150,000 patients in the United States are hospitalized each year with compression fractures. There stay in the hospital can average 8 days. The overall resulting costs are estimated to exceed $1.6 billion. So it is important to be able to show that a minimally invasive procedure like the balloon kyphoplasty is helpful in treating these fractures.
A recent article published in the journal Lancet evaluated the procedure for its efficacy and safety. The researchers were from 21 centers in eight countries. The controlled trial included 300 patients with one to three acute vertebral fractures. The patients were randomly assigned into a non-surgical care group (151 patients) or into the kyphoplasty treatment group (149 patients).
There was a greater increase in quality of life (physical component summary score) in the kyphoplasty group. There was no difference between the two groups when looking at adverse events. There were two serious adverse events related to the kyphoplasty (hematoma and urinary tract infection). There were other serious adverse events not related to the procedure (myocardial infarction and pulmonary embolism).
Their findings suggest that balloon kyphoplasty is an effective and safe procedure for patients with acute vertebral fractures.
Vertebral fractures, especially if multiple levels are involved, can change ones posture often creating a kyphosis (curved back). Over time this can become more pronounced, painful and debilitating. The forward curvature of the spine can also have a “compression effect” which may make it difficult to breathe, walk, eat, or sleep properly. Many of these fractures are related to osteoporosis. Patients with kyphosis have an estimated 24% increase in mortality compared to patients without compression fractures.
How the Balloon Kyphoplasty Works
Balloon kyphoplasty involves the placement of orthopedic balloons which are used to gently elevate the bone fragments in an attempt to return them to the correct position. Before the procedure X-rays or magnetic resonance imaging (MRI) are done to determine the exact location of the fracture.
Balloon kyphoplasty can be done under local or general anesthesia. Typically, the procedure takes less than one hour per fracture treated. It may require an overnight hospital stay.
To see photos and learn more about the procedure go to Spine Universe.
Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial; The Lancet, Volume 373, Issue 9668, Pages 1016 - 1024, 21 March 2009 (doi:10.1016/S0140-6736(09)60010-6); Prof Douglas Wardlaw FRCSEd, Prof Steven R Cummings MD, Jan Van Meirhaeghe MD, Prof Leonard Bastian MD, John B Tillman PhD, Jonas Ranstam PhD, Prof Richard Eastell MD, Peter Shabe MS, Karen Talmadge PhD, Prof Steven Boonen MD
National Osteoporosis Foundation