Kyphoplasty in SIngapore

Kyphoplasty is also known as balloon kyphoplasty. It is a minimally-invasive surgical procedure that can repair spinal fractures caused by cancer, osteoporosis, or benign lesions. It is not used for spinal stenosis treatment.

Kyphoplasty procedure is designed to relieve the intense pain caused by vertebral compression fractures, to stabilize the bone or to bring back some or all of the lost vertebral body height due to the compression fracture. Kyphoplasty or balloon kyphoplasty is a superb replacement of the typical conventional therapies such as analgesic use, bed rest, and bracing. It is a quick remedy for severe pain due to vertebral compression. It eliminates the pain almost immediately and the risk of complications during kyphoplasty is low. However, it is not intended for the treatment of arthritis or intervertebral disc disease. Kyphoplasty is different from discectomy, which is conducted in case of a herniated disc. Discectomy completely removes the damaged or herniated disc from the vertebrae of the patient.

Laminectomy and vertebroplasty are two other procedures that follow different techniques for stabilizing fractures. Laminectomy works by removing the lamina to create space, vertebroplasty works by injecting cement into the broken or cracked spine. For the same reason, vertebroplasty cost is different from kyphoplasty cost.

Who is the best candidate for kyphoplasty?

Kyphoplasty is typically suggested in case of:

• Severe pain that cannot be controlled by pain-relieving medications
• Severe functional restraints such as inability to walk or stand
• Fractures resulting in loss of height and alignment
• Multiple fractures in spine
• Fractures with radical collapse
• Fractures located at the thoracolumbar junction
• Spondylolisthesis, that is, displacement of one vertebra over another

Kyphoplasty starts by administering a local or general anaesthesia to the patient. The patient remains unconscious during the entire procedure, and therefore, is not able to feel anything. After the anaesthesia, the patient may receive antibiotics to prevent infection.The patient is then made to lie down on their stomach and is connected to the pulse, heart, and blood pressure monitors. The following the four steps in kyphoplasty procedure:

• Step 1:  The targeted area is cleaned and sterilized with a solution. The surgeon makes a narrow pathway into the fractured bone with a hollow needle (trocar). This incision site is about 1 cm in length. The surgeon guides the needle with the help of fluoroscopy.
• Step 2: Now a small orthopaedic balloon is inserted into the trocar. Usually, two balloons are used in the procedure, one on each side of the vertebral body. It gives better support to the bone as it moves back into position and increases the tendency of deformity correction.
• Step 3: Next, the balloon is gently inflated to create the space needed for the bone cement.
• Step 4: Once a room has been created, the mixture is injected to fill it up. Fluoroscopy helps the surgeon confirm that the mixture is distributed accurately. After the cement is in place, the balloons are deflated and removed with a trocar.

No stitches are required during the procedure, but the incision is bandaged. The bone cement dries rapidly and forms an internal cast that holds the vertebral body in place. Kyphoplasty procedure takes less than one hour if only one vertebra is being treated. 

• After kyphoplasty, you will have to stay in the recovery room for a short time. You may be allowed to get up and walk just after an hour of the procedure. However, you can feel some soreness that is common, but you should feel better within 48 hours of the procedure.
• Usually, kyphoplasty is done as an outpatient procedure, so you may be able to go home the same day. But in some cases, kyphoplasty is also performed after admitting the patient. In such cases, the patient is required to stay in the hospital overnight for monitoring. Inpatient session for kyphoplasty is conducted if the procedure involves more than one vertebra or if there are any complications. Avoid lifting heavy objects and strenuous activities for at least six weeks. Apply ice to the wound area if you have pain where the incision was made. The patient is typically able to conduct daily activities after one week of the procedure. However, strenuous exertion and heavy lifting should be avoided for at least six weeks. It is important to follow the instructions given by the doctor for a speedy recovery after kyphoplasty.

Typically, kyphoplasty does not have any severe side effects. You may experience some minor side discomfort such as soreness and redness of the skin. These problems usually resolve on their own or with minimal medical management. However, you should consult the doctor in case the symptoms persist for more than a few days.

The chances of risks and complications from kyphoplasty are overall low. But some complications may arise nonetheless. Extravasation is one such procedure that can take place in some cases but it is very rare. Extravasation refers to the leakage of bone cement from where it is supposed to stay. The risk of severe bleeding, nerve injury, spinal fluid leak, paralysis, and pulmonary embolus is less than two percent. Kyphoplasty is a safe procedure but call your doctor right away if you experience severe muscle pain, continues leg pain, back or rib pain that is really bad or gets worse over time, fever, numbness or tingling sensation, and weakness.