Balloon Kyphoplasty in Osteoporotic spinal fractures

Balloon Kyphoplasty in Osteoporotic spinal fractures :: Pix - TSE

Osteoporosis is a disease where there is decrease in bone mineral density and bone strength leading to increase risk of bone fractures. These fractures are commonly seen in spine and are called vertebral compression fractures.

In the world, nearly 1.4 million people suffer from this type of fracture every year. Risk factors of osteoporosis include old age, post menopausal women, smoking, steroids and certain medicines.

Despite conservative treatment with medications, bed rest, physiotherapy and braces, pain can persist for longer period or worsen with resulting spinal deformity leading to height loss, kyphosis (forward bending of spine), reduced lung function and immobility.

Surgery is not always advisable because of risk factors like increased age of the patients and associated comorbidities. Therefore, the role of BALLOON KYPHOPLASTY comes into play.

Balloon kyphoplasty (BKP) is a minimally invasive spinal procedure that uses bone cement (polymethyl methaacrylate) for stabilization of spinal fractures. It restores vertebral body height, reduces back pain, corrects spinal deformity, improves mobility and able to perform activities of daily living.

In short it improves the patient’s overall quality of life. This procedure takes one hour for each fracture treated and can be done under general or local anaesthesia.

Procedure: 

1. Balloon placement: Under C-arm (Xray control) guidance, using needle/cannula system, the balloon is placed into the vertebral body in both sides through the pedicles of the spine percutaneously.

2. Inflation of balloon: Once the balloon is in the vertebral body, they are inflated. This procedure raises the collapsed vertebra and corrects the deformity.

3. Filling of cement: The cavity created by the balloon is filled up with bone cement. This cement act as internal support to the vertebral body and prevents further collapse. It also increases the strength of the vertebra and provides relief of pain.

Most of the patients who have undergone Balloon kyphoplasty can be discharged from the hospital the following day. There will be relief of pain and ability to walk and move from the very next day after the procedure.

Studies have shown that after upto 2 years, patient who had undergone BKP has less pain than those who had standard treatment with physiotherapy and medications.

Any type of surgery carries a risk. Although with BKP these complications are low. There may be some risk like CVA, pulmonary embolism, leakage of cement, neurodeficit. The drawbacks of balloon kyphoplasty are its cost factor and is technically demanding.

To conclude balloon kyphoplasty is effective in treating pain due to osteoporotic vertebral compression fracture with added advantages of restoring vertebral body height and correcting spinal deformity without the patient having to undergo a major surgery.

---

* Dr Umesh S Takhelmayum wrote this article for The Sangai Express 

Dr Umesh S Takhelmayum, is an MBBS, MS (Ortho), Spine Fellow (Sir Gangaram Hospital, New Delhi), trained in spine surgery (Ganga Hospital, Coimbatore) and Ortho spine surgeon of JNIMS, Imphal. 

He can be reached at umeshta khelmayum2014(aT)gmail(doT)com 

Source : E-PAO , 6th Feb 2016