The goals of a kyphoplasty surgical procedure are designed to stop the pain caused by a spinal fracture, to stabilize the bone, and to restore some or all of the lost vertebral body height due to the compression fracture.
We have treated patients throughout the metroplex including patients from Southlake, Coppell, Carrollton, Richardson, Gainesville, Denton, Weatherford, McKinney, Frisco, Tyler and even treat patients from outside the state of Texas and in the International community. Â If you have any questions about the information below please feel free to contact us at any of our DFW locationsÂ conveniently located toÂ Dallas, Irving, Red Oak, Plano, Southlake, Grapevine, Colleyville and Duncanville.
Performing Kyphoplasty Surgery
- During kyphoplasty surgery, a small incision is made in the back through which I places a narrow tube. Using fluoroscopy to guide it to the correct position, the tube creates a path through the back into the fractured area through the pedicle of the involved vertebrae.
- Using X-ray images, I insert a special balloon through the tube and into the vertebrae, then gently and carefully inflates it. As the balloon inflates, it elevates the fracture, returning the pieces to a more normal position. It also compacts the soft inner bone to create a cavity inside the vertebrae.
- The balloon is removed and the doctor uses specially designed instruments under low pressure to fill the cavity with a cement-like material called polymethylmethacrylate (PMMA). After being injected, the pasty material hardens quickly, stabilizing the bone.
Kyphoplasty surgery to treat a fracture from osteoporosis is performed at a hospital under local or general anesthesia. Other logistics for a typical kyphoplasty procedure are:
- 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 Â hospital after the kyphoplasty procedure.
Patients should not drive until they are given approval by my office. If they are released the 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, although 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, including medications to prevent further bone loss.Â Â
Preparation before SurgeryÂ
Optimizing your physical condition before surgery will certainly improve your recovery and outcome. Maintain a healthy, 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 opiod pain medications, as decreased preoperative utilization correlates with both better long term outcomes and allows for more reliable postoperative pain management.
Risks of Surgery
Some general surgical risks apply to kyphoplasty, including a reaction to anesthesia and infection. Other risks that are specific to the kyphoplasty procedure include:
- Nerve damage or a spinal cord injury from malpositioned 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:
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, but human studies have not been done. Osteoporosis is a chronic, progressive disease. As stated earlier, patients who have sustained fractures from osteoporosis are at an increased risk for additional fractures due to the loss of bone strength caused by osteoporosis.
The Spine Physicians Institute and Dr. Venkat Sethuraman pride ourselves in having an extremely low complication rate, far below the published norms. We attribute this to having greater than ten years of experience, constantly staying up to date with the spine surgical literature, and the fellowship training Dr. Sethuraman received at the Mayo Clinic in Rochester, Minnesota as well as the expert fellowship training our other team of surgeons have received.
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 by providing critical information and alerts to surgeons of potential harm or compromise to the spinal cord or neural structures.Â IONM provides better insight into a patient’s condition during surgery to support better decision-making that enables the practice of better medicine.Â On the day of your surgery you will meet a member of IONM team that 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 have.Â After the surgery, you can expect to have a spinal brace in place.Â I think all patients need some time at home recovering after surgery, usually at least a week. During the postoperative period, you will observe restrictions to your activity level to the level you feel are warranted. During the first six weeks as you are wearing the spinal brace as you feel is needed. Some patients wear the brace for the entire 6 weeks others rapidly discontinue using it. 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, I recommend allowing the back to fully heal which requires an entire 6 weeks off of work. Generally, I 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 are always based on your consensus.
When you arrive for your surgery, you will meet the anesthesiologist, neuromonitoring technician, and surgical nurses.Â They will discuss with you their procedures and probably make you feel more at ease. Usually, general anesthesia will be given for your surgery. You will be given antibiotics to prevent infection, and support stockings along with sequential compression devices will be placed on your legs. We will then go to operating room and I will perform your procedure. Most lumbar laminectomies require between one to two hours, and postoperatively you spend about an hour in the recovery team. Â During the surgery, I will call out to the waiting room and give your family routine updates. Afterwards, routinely patients are transferred back to the day surgery unit where they started and are discharged home.
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. You usually will be 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 their date of surgery. I will check radiographs of your back. At that time we will discontinue the brace if you have already not done this on your own. We offer several convenient locations throughout Dallas, Red Oak, Irving and Plano where you may schedule your visit.
Successful Kyphoplasty Surgery not only is the result of the procedure, but also very importantly is the result of aftercare and rehabilitation. The initial rehab program is simply composed of performing routine day to day activities while observing your post-operative restrictions. I encourage patients to participate in a daily walking program, progressing at their level of comfort.
We do not start this formal physical therapy until the six week postoperative visit, if warranted.
During this process, please do not hesitate to ask questions. My team is always available to help you. Our goal is to give you best possible care in the most safe and pleasant way possible. Although surgery is not always â€œeasyâ€ for you and requires some work, remember that you are having the surgery because we expect a good result. I wish you a speedy recovery. For information about any of conveniently located offices nearÂ Dallas, Irving, Red Oak, Plano, Southlake, Grapevine, Colleyville and Duncanville,Â please visit our Locations and Hours page on our website. We treat patients throughout the Dallas, Fort Worth metroplex including patientsÂ from Southlake, Coppell, Carrollton, Richardson, Gainesville, Denton, Weatherford, McKinney, Frisco, Tyler and even treat patients from outside the state of Texas and in the International community.
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