Kyphoplasty is a medical procedure designed to treat specific types of spinal fractures, aiming to alleviate pain and restore vertebral height. This minimally invasive intervention stabilizes weakened areas of the spine, specifically the vertebral bodies, which are the block-like bones of the spinal column.
Understanding Kyphoplasty
Kyphoplasty treats vertebral compression fractures (VCFs), often resulting from osteoporosis, trauma, or certain tumors. These fractures cause the vertebral body to collapse, leading to significant back pain, height loss, and spinal deformity.
A small incision is made in the patient’s back to access the fractured vertebra. A specialized balloon, known as a bone tamp, is inserted into the compressed bone. The balloon is then gently inflated to create a cavity within the vertebral body and restore its original height.
After the balloon is deflated and removed, the created space is filled with bone cement, typically polymethyl methacrylate (PMMA). This cement hardens rapidly, stabilizing the fractured bone and preventing further collapse.
X-ray Guidance During Kyphoplasty
X-ray guidance, specifically real-time fluoroscopy, is continuously employed throughout kyphoplasty. This live imaging allows the surgeon to visualize the spine and instruments for precision and safety. Fluoroscopy guides the placement of a small needle, often through the pedicle, into the fractured vertebral body.
Fluoroscopy also monitors the advancement of the bone tamp and the inflation of the balloon within the vertebral body. This visualization ensures the balloon expands correctly to create an appropriate cavity while avoiding damage to surrounding delicate structures like the spinal cord or nerve roots. The surgeon observes the balloon’s effect on the fractured bone, confirming reduction of the compression.
X-ray imaging also guides the injection of bone cement into the newly created cavity, allowing observation of its flow and distribution. This ensures it fills the space completely and uniformly. Visual feedback prevents cement from leaking outside the vertebral body into unintended areas, such as the spinal canal, adjacent disc spaces, or blood vessels, which could lead to complications.
Post-Procedure X-ray Imaging
Following kyphoplasty, X-ray imaging is routinely performed to evaluate the immediate outcome. Post-operative images confirm the placement and distribution of bone cement within the treated vertebra, providing clear visualization.
X-rays also assess the degree of vertebral height restoration. By comparing these images with pre-operative X-rays, clinicians determine the extent to which the collapsed bone has been re-expanded.
Post-procedure X-rays monitor for potential complications, such as cement leakage into surrounding tissues or adjacent structures. These images serve as an immediate diagnostic tool to detect unexpected findings. They also establish a baseline for future comparisons, useful if follow-up imaging is required to monitor long-term stability or address new symptoms.