ePainBook: Vertebroplasty/Kyphoplasty - Presented by Arizona Pain Specialists

Pain medicine, pain management, fibromyalgia, Arizona pain, back pain, pain treatment, discography, back pain, neck pain, migraine., headaches, sciatica, muscle pain, Arizona pain center, acupuncture, arthritis, Arizona, Scottsdale, phoenix.

The syndromes most commonly requiring Vertebroplasty & Kyphoplasty include:

• Osteoporosis
• Bone cancer metastasis
• Trauma

Procedure

Vertebroplasty is an outpatient technique that involves injecting acrylic cement with a biopsy needle into the fractured
painful vertebra. The needle is placed with x-ray guidance for proper placement. The acrylic cement quickly dries and
forms a support structure within the vertebra that provide stabilization and strength. The needle makes a small puncture
in your skin that is easily covered with a small bandage after the procedure. For your comfort, patients are given local
anesthesia and light sedation for the procedure.

Kyphoplasty is also referred to Balloon Assisted Vertebroplasty. This method involves placing needles into the fractured
vertebra and placing a strong inflatable balloon into the vertebra under x-ray. When the balloon is inflated, it makes a
space in the center of the vertebrae, where acrylic cement can be injected using low pressure. The technique works very
similarly to Vertebroplasty, but the inflation of the balloon may result in an increase in the vertebral body height.

Benefits

Vertebroplasty is a frequently used ground breaking procedure that has proven to reduce pain, increase vertebral body
height, and decrease wedge angle without worsening of the retropulsion of the vertebrae (Hiwatashi 2007). Kyphoplasty
has also been shown to restore vertebral height and vertical alignment that was damaged by the collapse of the
vertebrae.
Patients with compression fractures typically exhibit kyphosis. Kyphosis or “hump back” is curving of the spine due to the
collapse of the vertebrae. This can be very debilitating and embarrassing for the person who experiences it.

In a 2006 study, Kyphoplasty was shown to enhance height reduction and accounted for over 80% of the height
restoration that was lost. Kyphoplasty also showed that 90.7% of fractures improved following procedure (Shindle 2006).
If height restoration is considered to be a goal then Kyphoplasty may have some advantages over Vertebroplasty.

Risks

As with all medications and surgical procedures, there is always a risk of complications.
Kyphoplasty and Vertebroplasty are considered appropriate non-surgical minimally invasive treatments for many patients
who suffer from back pain. Some of the associated risks that can be produced are from the leak of acrylic cement outside
of the vertebral body. Although severe complications are extremely rare, it is important to know that infection, bleeding,
numbness, tingling, headache, and paralysis may ensue due to misplacement of the needle or cement. This particular
risk is decreased by the use of x-ray or other radiological imaging to ensure proper placement of the cement.

Although there are potential risks, published studies indicate that Kyphoplasty and Vertebroplasty are safe methods of
treating painful vertebral compression fractures and complications are rare with these procedures (DaFonseca 2006)
(Hiwatashi 2007).

Outcome

Fracture Prevention: A balanced diet, regular exercise, weight lifting, calcium, vitamin D supplements, and
bisphosphonates (like Fosamax) may help prevent additional compression fractures due to Osteoporosis. These
treatments strengthen bone and prevent further loss in bone density. If you do suffer a painful compression fractures,
you may be good candidates for minimally invasive procedures that have been proven effective, including Vertebroplasty
and Kyphoplasty (Old 2004).

Vertebroplasty and Kyphoplasty are exhilarating new techniques that provide therapeutic benefit by significantly reducing
pain and improving mobility in patients with vertebral fractures. In a 2007 report it was noted that 95% of people treated
with these procedures showed partial or complete immediate pain relief (Hiwatashi 2007). The American Society of
Interventional Pain Physicians developed a large evidence-based practice guideline for the management of chronic spinal
pain with interventional techniques. The article stated that for vertebral augmentation procedures, the evidence of relief
and improvement is moderate for both Vertebroplasty and Kyphoplasty. (Boswell 2007).

If you are suffering from chronic back pain due to a compression fracture contact Arizona Pain Specialists today to see if
you can benefit from these state of the art treatments.

Journal Articles

Vertebral height restoration in osteoporotic compression fractures: kyphoplasty balloon tamp is superior to postural
correction alone. Shindle MK, Gardner MJ, Koob J, Bukata S, Cabin JA, Lane JM. Osteoporosis Int. 2006 Dec;17(12):1815-
9. Epub 2006 Sep 16 PMID: 16983458

[Balloon kyphoplasty in the therapy of vertebral fractures] DaFonseca K, Baier M, Grafe I, Libicher M, Noeldge G, Kasperk
C, Meeder PJ. Orthopade. 2006 Oct;35(10):1101-9 PMID: 17195295

Interventional techniques: evidence-based practice guidelines in the management of chronic spinal pain. Boswell MV,
Trescot AM, Datta S, Schultz DM, Hansen HC, Abdi S, Sehgal N, Shah RV, Singh V, Benyamin RM, Patel VB,
Buenaventura RM, Colson JD, Cordner HJ, Epter RS, Jasper JF, Dunbar EE, Atluri SL, Bowman RC, Deer TR, Swicegood
JR, Staats PS, Smith HS, Burton AW, Kloth DS, Giordano J, Manchikanti L; American Society of Interventional Pain
Physicians. Pain Physician. 2007 Jan;10(1):7-111 PMID: 17256025

Vertebroplasty for osteoporotic fractures with spinal canal compromise Hiwatashi A, Westesson PL. AJNR Am J
Neuroradiol. 2007 Apr;28(4):690-2 PMID: 17416822

Treatment of painful osteoporotic or traumatic vertebral compression fractures by percutaneous vertebral augmentation
procedures: a nonrandomized comparison between vertebroplasty and kyphoplasty. De Negri P, Tirri T, Paternoster G,
Modano P. Clin J Pain. 2007 Jun;23(5):425-30 PMID: 17515741

Vertebral Compression Fractures in the Elderly. Old, Jerry; Calvert, Michelle. American Family Physician. January 1, 2004

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Vertebroplasty and Kyphoplasty
by Nicole Berardoni M.D, Paul Lynch M.D, and Tory McJunkin M.D
Phoenix, Scottsdale, Arizona, Pain Management, Pain Clinic, Pain, and back Pain

Vertebropasty and Kyphoplasty are two innovative, minimally
invasive, non-surgical procedures that have proven to
strengthen the vertebrae of your spine and significantly improve
pain caused by vertebral body compression fractures. Fractures
are often secondary to osteoporosis, cancer metastasis, or
trauma. Arizona Pain Specialists is happy to provide these
treatments to the Phoenix area. These exciting new therapies
have helped people even when conservative therapies have not
provided adequate relief (De Negri 2007).

Book I - Pain Syndromes

Chapter 1     Low Back Pain
Chapter 2     Neck Pain
Chapter 3     Cancer Pain
Chapter 4     Headaches
Chapter 5     Spinal Stenosis
Chapter 6     Sciatica
Chapter 7     Arthritis
Chapter 8     Fibromyalgia
Chapter 9     Motor Vehicle Injuries
Chapter 10   Complex Regional Pain
Syndrome
Chapter 11   Vertebral Body
Fractures
Chapter 12   Hip and Leg Pain
Chapter 13   Diabetic Peripheral
Neuropathy

Book II - Interventional Procedures

Chapter 14   Epidural Steroid
Injection
Chapter 15   Facet Injections/Medial
Branch Blocks
Chapter 16   Radiofrequency Ablation
Chapter 17   Spinal Cord Stimulator
Implants
Chapter 18   IntraDiscal
Electrothermal Therapy (IDET)
Chapter 19
Vertebroplasty/Kyphoplasty
Chapter 20   Discography
Chapter 21   Percutaneous
Discectomy
Chapter 22   Occipital Nerve Block
Chapter 23   Sympathetic Block
Chapter 24   Stellate Ganglion Block
Chapter 25   Intrathecal Pump
Implants
Chapter 26   Caudal Steroid Injection
Chapter 27   Adhesiolysis
Chapter 28   Cervical Steroid
Injection
Chapter 29   Sacroiliac Joint
Injections
Chapter 30   Celiac Plexus Block
Chapter 31   Head and Neck
Procedures
Chapter 32   Joint Injections
Chapter 33   Continuous Catheter
Nerve Blocks
Chapter 34   Peripheral Nerve
Stimulation/Field Stimulation
Chapter 35   Disc Denervation

Book III   Other Treatments

Chapter 36   Medication Management
Chapter 37   Acupuncture
Chapter 38   Prolotherapy
Chapter 39   Botox
Chapter 40   Massage
Chapter 41   Alternative and
Complementary Medicines
Chapter 42   Exercise and Nutrition
Counseling
Chapter 43   Prayer
Chapter 44   Cognitive Behavioral
Therapy
Chapter 45   Group Therapy
Chapter 46   Biofeedback
Chapter 47   Chiropractic
Manipulations
Chapter 48   Vitamin Supplements
Chapter 49   Customized
Pharmaceutical Formulations
Chapter 50   Hormone Therapy

Frequently Asked Questions