Vertebroplasty and kyphoplasty are minimally invasive procedures to treat painful vertebral compression fractures by injecting bone cement into the collapsed vertebra. These fractures are most commonly caused by osteoporosis.
Under X-ray guidance, a needle is inserted through the skin of the back into the fractured vertebra. In vertebroplasty, bone cement is injected directly. In kyphoplasty, a balloon is first inflated inside the vertebra to restore height before cement is injected. The cement hardens within minutes, stabilising the fracture. The procedure takes 30–60 minutes per level and is performed through one or two small puncture wounds.
These procedures are considered for painful osteoporotic vertebral compression fractures that have not responded to four to six weeks of pain management, bracing, and activity modification. They are also used for certain pathological fractures from tumours.
Pain medication, bracing, physiotherapy, and time. Many vertebral compression fractures improve with conservative management over six to twelve weeks. Osteoporosis treatment should be optimised regardless of whether the fracture is treated surgically.
MRI scan to confirm the fracture is recent and likely to be the source of pain. Blood tests including clotting studies. This is usually a day-case or overnight procedure.
Rapid pain relief is the primary benefit. Most patients experience significant improvement within 24–48 hours. Kyphoplasty may also partially restore vertebral height and reduce spinal deformity.
Temporary local pain where the needle was inserted.
Not all patients achieve full pain relief.
Cement may leak outside the vertebra. Usually asymptomatic but can rarely cause nerve compression.
Stiffening one vertebra may increase stress on adjacent levels, leading to new fractures.
Very rare.
From leaked cement. May require urgent decompression surgery.
Cement entering the venous system and travelling to the lungs. Very rare but potentially serious.
Can be performed under local anaesthesia with sedation, or under general anaesthesia. The patient is positioned face down.
Most patients mobilise within hours and go home the same day or the next day. Walking is encouraged immediately. Pain relief is often rapid. Osteoporosis treatment should be started or optimised. Physiotherapy for back strengthening and balance.
Review at two to four weeks. Osteoporosis management is essential to prevent further fractures.
Many patients notice significant improvement within 24–48 hours. Some improve immediately.
Yes, the cement is permanent and maintains its strength indefinitely.
Yes. Vertebroplasty treats the fracture but not the underlying osteoporosis. Medication to strengthen bones and prevent further fractures is essential.