Kyphoplasty is a medical term that describes surgery to create an opening between or expanding the space between vertebrae that have collapsed. Collapsed vertebrae are commonly found in individuals diagnosed with osteoporosis in the spine. Osteoporosis is a condition that causes weakened or porous bone structure, leading to weaken fragile bones easily that are easily fractured, often resulting in a humped or bowed spine.
Osteoporosis in the spine causes the supportive structure of the spinal column to weaken, often resulting in bones rubbing together, collapsing in on themselves, and causing pain, stiffness, pinched nerves, limited mobility and severely reduced range of motion.
Kyphoplasty benefits individuals diagnosed with osteoporosis in the spine. Those diagnosed with other spinal conditions that result in damage or destruction of the vertebra may also benefit from the kyphoplasty procedure. However, the procedure is not designed to help those with full deformities of the spine and even some patients with osteoporosis may not be qualified for the procedure.
The most likely candidates for a successful kyphoplasty procedure are those who have experienced recent compression fractures in the spine. Doctors recommend that the procedure be performed within two months of the fracture for the most beneficial and effective outcomes.
Kyphoplasty is a procedure that involves the insertion of a special surgical instrument called an endoscope into the spaces between the vertebrae. A balloon threaded onto a guide wire is attached to the end of the device, inserted in between the compressed vertebrae and then inflated. This forces the vertebral bones to move further apart, expanding the bone. The space is then filled with a special type of bone cement to help repair spine deformities, reduce pain caused by pinched or compressed nerves, and help to alleviate or reduce hunching of the spinal structure.
During the surgical procedure, an incision is made in the back at the site of the damaged vertebrae. The doctor inserts an endoscope into the incision. The endoscope is a special surgical tool shaped much like a large straw. A camera is attached to one end, as well as a light. Images taken by the camera are sent through the endoscope to a special viewing monitor or screen in the operating room. This enables surgeons to provide minimally invasive surgical procedures and make smaller incisions, reducing the risk of internal damage, bleeding and postoperative pain.
After the insertion, the doctor utilizes an imaging process called fluoroscopy in order to help him guide the wires, via the endoscope, into the proper position within the spinal column. Making very small and precise movements and guided by fluoroscopy, the doctor then places the special surgical balloon into the vertebral spaces. The balloon is then slowly inflated, much like a tire filling with air. As the balloon inflates, the damaged vertebrae slowly return to their normal anatomical positioning. This process also enables bone damaged by osteoporosis to compact, leaving an open space within the vertebra.
Special cement is inserted into the spaces. The cement is called polymethymethacrylate or PMMA for short. The surgical cement hardens quickly and helps to stabilize the bone and hold it into a more correct position.
The length of kyphoplasty procedures depend on how many vertebrae need to be repaired. Generally, surgeons allow about one hour per vertebrae treated. Following the surgery, patients are taken to a recovery room, where they may spend one or two days in the hospital. Patients will be guided regarding activities but in most cases fully recover within about six weeks.
Kyphoplasty procedures are performed by orthopedic spine surgeons or narrow surgeons, perhaps both, depending on location of the damage vertebra, surrounding nerves and blood vessels, and severity of the damaged vertebral structure. Orthopedic surgeons generally have five years of orthopedic surgical experience while neurosurgeons have between six and seven years of surgical experience, in addition to training and experience in endoscopic and laparoscopic approaches to spine surgery.
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