Kyphoplasty

What you should know

• Kyphoplasty (KP) is a procedure to fix your broken vertebrae. Your vertebrae are the bones in your back that are linked together to form your spine. Your vertebrae help your spine and body support your weight. Your spine surrounds your spinal cord, which contains your nerves. KP is done to treat vertebral compression fractures. A vertebral compression fracture is a crack or break in one or more bones in your spine. When your vertebra is broken, it may collapse and lose its height. Vertebral compression fractures are normally caused by osteoporosis and tumors. You may get a vertebral compression fracture from an injury, such as a fall.
  
  
• Vertebral compression fractures may be very painful. You may have changes in your mood and trouble doing your normal activities. The shape of your spine may change, and shorten your height. During KP, bone cement is used to fill the breaks in your vertebrae. Having KP may decrease your pain and make your vertebrae stronger. KP may help straighten your spine and increase your height. KP may also help increase your movement and ability to do your daily activities.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

• You may have an allergic response to the anesthesia medicine or bone cement used during your procedure. An allergic response may include a skin rash, swelling, and trouble breathing. During surgery, your nerves and spinal cord may be damaged. Spinal cord damage may cause you to leak spinal fluid, and you may become unable to move. After surgery, you may have bruising, increased pain, and you may get an infection. You may get fractures of nearby vertebrae or other bones, such as your ribs. Cement may leak into your spinal cord, kidneys, and blood vessels. Cement leaks may travel into your lungs and brain, and you may die.
  
  
• If you do not have the KP, your pain may continue to get worse. You may become very depressed and have problems with anxiety. The changes in the curve of your spine may make it harder for you to breathe. You may have more trouble walking and doing the activities you enjoy. The less you move, the weaker you may become. Decreased movement may also cause skin sores and blood clots may form in your blood vessels. The blood clots can travel to your heart and lungs, and you may die. Talk to caregiver if you have questions about your procedure or care.

Getting Ready

Before your procedure:

• Ask a family member or friend to drive you home when you are ready to leave the hospital. Do not drive yourself home.
  
  
• Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.
  
  
• Ask your caregiver if you need to stop using aspirin, prescribed, or other over-the-counter medicine before your procedure.
  
  
• Imaging tests may be needed to look at your vertebrae and spinal cord before your procedure. Imaging tests include a spinal x-ray, computed tomography (CT) scan, magnetic resonance imaging (MRI), or a bone scan. You also may need blood tests before your procedure. Ask your caregiver for more information about these and other tests you may need. Write down the date, time, and location of each test.

The night before your procedure:

Ask caregivers about directions for eating and drinking.

The day of your procedure:

• Write down the correct date, time, and location of your procedure.
  
  
• Ask your caregiver before taking any medicine on the day of your procedure. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring a list of all the medicines you take, or your pill bottles, with you to the hospital.
  
  
• You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.
  
  
• Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
  
  
• An anesthesiologist may talk to you before your surgery. This caregiver may give you medicine to make you sleepy before your procedure or surgery. Tell your caregiver if you or anyone in your family has had a problem using anesthesia in the past.

Treatment

What will happen?

• You will be taken to the room where your procedure will be done. You will lie on your stomach on a table or bed. You may have pillows under your hips and feet to help support your spine. You may be given general anesthesia medicine to help you fall, and stay asleep. Local anesthesia medicine also may be given as a shot to numb the area where your procedure will be done. Your caregiver may give you antibiotic medicine to prevent an infection from germs called bacteria. Fluoroscopy (a special x-ray) will be used to locate your broken vertebrae, and guide your caregiver during the procedure.
  
  
• A small incision may be made over your broken vertebrae where a needle will be inserted. Your caregiver also may use only the needle to reach your broken vertebrae. A tube will be place over the needle, and the needle will be removed. A small drill will be put into the cannula to make a path into your vertebrae. The drill will be removed, and a small balloon will be put through the cannula. The balloon will be enlarged to make a pocket in the vertebrae. The balloon will be removed, and bone cement will be injected into the cavity. After the bone cement is injected, the cannula will be removed. A bandage may be placed over the area where your procedure was done. Your caregiver may do an x-ray or CT scan to check for any cement leaks.

After your procedure:

You will be taken to a room where you can rest until you are fully awake. You will have to lie flat for about 1-2 hours so the cement can harden. Do not get out of bed until your caregiver says it is okay. A caregiver may remove your bandage soon after your procedure to check your wound. Once caregivers see that you are not having any problems, you may be able to go home. If you are staying in the hospital, you may be taken back to your room.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

• You cannot make it to your procedure.
  
  
• You have a fever.
  
  
• You have worsening pain that travels to your legs.
  
  
• You have increased trouble walking or moving around.

Seek Care Immediately if

• You are unable to move one or both of your legs.
  
  
• You have pain in your rib area or lower back.
  
  
• You have sudden trouble breathing or chest pain.