Kyphoplasty Surgery

Kyphoplasty Surgery

The Kyphoplasty Surgery is designed to stop the pain caused by a spinal fracture. It stabilizes the bone and restores some or all lost vertebral body height due to the compression fracture.
If you have any questions after reading this information about kyphoplasty surgery, please call us. We, at Spine Physicians Institute, have successfully performed this procedure on countless patients over the years.

Step-by-Step Procedure of Kyphoplasty Surgery

• During kyphoplasty surgery, a small incision is made in the back.
• The surgeon places a narrow tube through this incision.
• Fluoroscopy is used to guide the narrow tube to a correct position. The tube creates a path through the back into the fractured area through the pedicle of the involved vertebrae.
• The surgeon inserts a balloon through the tube and into the vertebrae. X-ray images are used to ensure correct positioning. The balloon is the gently and carefully inflated.
• As the balloon inflates, it elevates the fracture. The fractured pieces are returned to a more normal position. It also compacts the soft inner bone to create a cavity inside the vertebrae.
• Once the balloon is removed, the surgeon uses specially designed instruments. These instruments are used under low pressure to fill the cavity with a cement-like material called polymethylmethacrylate (PMMA).
• After being injected, the pasty material hardens quickly. Hence the bone is stabilized.

Various Considerations in Kyphoplasty Surgery

Kyphoplasty surgery is performed to treat a fracture from osteoporosis. It is typically done at a hospital under local or general anaesthesia. Other logistics for a typical kyphoplasty procedure includes;

• The kyphoplasty procedure takes about one hour for each vertebra involved.
• Patients will be observed closely in the recovery room immediately following the kyphoplasty procedure.
• Patients are discharged to home from the hospital after the kyphoplasty procedure.

Patients should not drive until they are given approval by the surgeon’s office. If they are released day of the kyphoplasty surgery, they will need to arrange for transportation home from the hospital.
Pain relief will be immediate for some patients. In others, elimination or reduction of pain is reported within two days. At home, patients can return to their normal daily activities. However, strenuous exertion, such as heavy lifting should be avoided for at least six weeks.
Patients should see their family doctor to begin or review their treatment plan for osteoporosis. This plan must include medications to prevent further bone loss.

Preparation before Surgery

• Optimizing your physical condition before the actual surgery can immensely improve your recovery and outcome.
• You must maintain a healthy and balanced diet before surgery.
• Stop Smoking. Smoking can significantly delay healing, increase risks, and adversely affect outcomes. Smoking cessation cannot occur with use of nicotine supplements such as nicotine patches and nicotine gum.
• Prior to surgery, try to minimize the use opioid pain medications. The decreased preoperative utilization of opioids correlates with better long-term outcomes. It also allows for more reliable postoperative pain management.

Risks of Surgery

Some general surgical risks apply to kyphoplasty. These including an adverse reaction to anaesthesia and infection. Other risks that are specific to the kyphoplasty procedure include;

• Nerve damage or a spinal cord injury from mispositioned instruments placed in the back
• Nerve injury or spinal cord compression from leaking of the PMMA into veins or epidural space
• Allergic reaction to the solution used to see the balloon on the x-ray image as it inflates

New Study Results:

New information is available from a clinical trial on balloon kyphoplasty. Read our review of the findings here;

Balloon Kyphoplasty
It is not known whether kyphoplasty will increase the number of fractures at adjacent levels of the spine. Bench studies on treated bone have shown that inserting PMMA does not change the stiffness of the bone. However, human studies have not been done yet.
Osteoporosis is a chronic, progressive disease. As stated earlier, patients who have sustained fractures from osteoporosis are at an increased risk for additional fractures. This happens due to the loss of bone strength caused by osteoporosis.

Minimization of Risks

The Spine Physicians Institute and Dr. Venkat Sethuraman pride ourselves in having an extremely low complication rate. It is far below the published norms. We attribute this to having greater than ten years of experience and constantly staying up to date with the spine surgical literature. We also have a claim to the superior fellowship training Dr. Sethuraman received at the Mayo Clinic in Rochester, Minnesota. Moreover, the expert fellowship training our other team of surgeons have received is also equally valuable.
Risks are further minimized by the utilization of Intraoperative Neuromonitoring (IONM). IONM offers insight into the nervous system during spinal surgeries. Use of IONM facilitates the surgical process and can reduce surgical risk. It can provide critical information and alerts to surgeons of potential harm or compromise to spinal cord or neural structures. IONM provides better insight into a patient’s condition during surgery to support better decision-making that enables the practice of better medicine.
On the day of your surgery you will meet a member of IONM team. He or she will provide your neuromonitoring for you during your surgery.

Time Away from Work

How much time you need off work primarily depends on the type of work you do. After the surgery, you can expect to have a spinal brace in place. We recommend that all patients need some time at home recovering after surgery. This time must last at least a week. During the postoperative period, you must observe restrictions to your normal activities. You must reduce them to a level you feel are warranted.
During the first six weeks as you must wear the lumbar brace. Some patients wear the brace for the entire 6 weeks. While others rapidly discontinue using it. You should not drive a car for the first 6 weeks.
You should not drive a car for the first 6 weeks.
If your job is sedentary, then you may feel comfortable returning to work within a few days. However, if your work is very strenuous, we recommend allowing the back to fully heal. It might take an entire 6 weeks off of work.
Generally, we advise patients to inform their employers that they are going to require 6 weeks to recover. If post-operatively, you feel you can return sooner, our office will always be happy to provide the proper documentation to you to allow for such. Remember, no one knows your work environment better then you, thus our work release is always based on patient’s consensus.

The Procedure

When you arrive for your surgery, you will meet the anaesthesiologist, neuromonitoring technician, and surgical nurses. They will discuss with you their procedures and probably make you feel more at ease. Usually, general anaesthesia will be given for your surgery. You will be given antibiotics to prevent infection, and support stockings. The sequential compression devices will be placed on your legs. The surgeon will then go to operating room and perform the procedure.
Most lumbar laminectomies require between one to two hours, and postoperatively you spend about an hour in the recovery team. During the surgery, the surgeon will call out to the waiting room and give your family routine updates. Afterwards, patients are transferred back to the day surgery unit where they started. Then they are discharged home.

Aftercare

When you awaken after surgery, you will receive pain medication and your nurses will closely monitor you. You will have a postoperative in place usually. You will resume a normal diet and be mobilized immediately after surgery. The patient is usually discharged the day of surgery. On discharge, you will be given a detail set of discharge instructions and prescription pain medications.
The support stockings you are given in the hospital should be utilized for the first six weeks after surgery. These reduce the risk of blood clots after surgery.
You will return for your first postop visit usually six weeks after the date of your surgery. We will check radiographs of your back. At that time, we will discontinue the brace if you have already not done this on your own.

Rehab

Successful Kyphoplasty Surgery not only consists of not only a correct procedure, but also aftercare and rehabilitation. The initial rehab program is simply composed of performing routine day to day activities while observing your post-operative restrictions. We encourage patients to participate in a daily walking program, progressing at their level of comfort. We do not start formal outpatient physical therapy until the six-week postoperative visit, if warranted.
During this process, please do not hesitate to ask questions. Our team is always available to help you at any of our spine health centres. Our goal is to give you best possible care in the most safe and pleasant way possible. Although surgery is not always easy for a patient. It requires a lot of work. Regardless, you must remember that you are having the surgery because we expect a good result. We wish you a speedy recovery.
For more questions, contact our offices located in Dallas, Irving, Red Oak, Plano, Southlake, Grapevine, Colleyville and Duncanville marketplaces. Please visit our Locations and Hours page on our website. We treat patients throughout the Dallas, Fort Worth metroplex including patients from Southlake, Coppell, Carrollton, Richardson, Gainesville, Denton, Weatherford, McKinney, Frisco, Tyler. We even treat patients from outside the state of Texas and in the International community.