Who is a candidate?
Kyphoplasty is considered for a vertebral compression fracture causing severe, focal pain that has not settled with appropriate non-operative care, where MRI confirms the fracture is recent and still healing. Most compression fractures do not need it. They settle with pain control, brief activity modification, and treatment of the underlying bone weakness.
Urgent
Kyphoplasty is not appropriate where the fracture is causing pressure on the spinal cord or nerves, or where the spine is unstable. Those situations need a different operation.
How the procedure works
Under X-ray guidance, a needle is passed through the pedicle into the collapsed vertebral body. A small balloon is inflated to create a cavity and lift the bone, then removed. Bone cement is injected into that cavity under low pressure and allowed to harden, internally splinting the fracture. The incisions are small enough to need little more than a dressing.
Recovery
Most people go home the same day. Pain relief is often noticeable within one to two days. Walking is encouraged immediately. Because the fracture usually signals underlying bone weakness, attention turns quickly to osteoporosis treatment, calcium and vitamin D, fall prevention, and physical therapy for posture and strength.
Benefits and alternatives
The intended benefit is faster relief of fracture pain and earlier return to activity than waiting for natural healing, in patients whose pain has not responded to conservative care. Alternatives are continued non-operative treatment (analgesia, bracing, and time), which remains appropriate for the majority, and open stabilization where the fracture is unstable.
Risks
Risks include infection, bleeding, and cement leaking outside the vertebral body, which is usually harmless but can occasionally irritate or compress a nerve. Fracture of an adjacent vertebra can occur afterwards, which is why treating the underlying bone disease matters as much as treating the fracture itself.