A variety of extra-arch puncture methods have been successfully used for percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP).
Percutaneous vertebroplasty (PVP) is a treatment for patients with one or more symptomatic vertebral fractures caused by bone tumors, osteoporosis or trauma. In PVP, a bone biopsy needle is inserted into the fractured vertebrae under local anesthesia in the patient; a bone cement made of polymethylmethacrylate (PMMA) is injected through the needle, followed by immediate relief of symptoms such as difficulty walking or low back pain . A single PVP procedure requires only 2 hours of treatment time and 2 hours of postoperative bed rest; it can be performed through a 5-mm skin incision for insertion of each bone biopsy needle, it has a low incidence of serious adverse events, can be performed without special preoperative preparation or intensive postoperative care, and the only absolute contraindications are uncontrollable infection and bleeding tendencies.PVP, as a minimally invasive procedure, has a low complication rate It is also characterized by the fact that patients can go home after treatment without hospitalization and can treat elderly patients over 90 years of age with guaranteed outcomes.
Percutaneous kyphoplasty (PKP) is currently an effective and widely used treatment for osteoporotic vertebral compression fractures (OVCF), which is usually performed under local anesthesia and is well tolerated by patients. Early studies have shown promising clinical outcomes in terms of immediate pain relief and improved function, especially in the elderly. However, there is still a very high number of patients who are not satisfied with the post-surgical results. As for these patients, they complain of unsatisfactory or no change in their pain relief or even worse pain, which may indicate persistent compression or recurrent fractures in the treated vertebrae. Previous studies have shown that intravertebral vacuum clefting (IVC) in acute OVCF is not an uncommon phenomenon and is also considered an important risk factor for persistent back pain and severe vertebral collapse, which may be the main reason for unsatisfactory outcomes after PKP.
Balloon kyphoplasty is a minimally invasive procedure designed to repair vertebral compression fractures (VCF) by reducing and stabilizing fractures. It treats pathological vertebral fractures caused by osteoporosis, cancer or benign lesions.
The surgeon will make a pathway into the fractured vertebra using a hollow instrument. A small balloon is then guided through the instrument into the bone.
Once in position, the balloon is slowly inflated to gently raise the collapsed bone into its normal position.
When the bone is in the correct position, the surgeon deflates and removes the balloon. This leaves behind a void—or cavity—within the vertebral body.
To prevent the bone from collapsing again, the void is filled with orthopaedic cement.
Once set, the cement forms a cast inside the vertebral body that stabilizes the bone. To fully secure the bone, the procedure is sometimes performed on both sides of the vertebral body.
A shorter surgical time; the procedure usually takes about a half hour per spinal level.
The kyphoplasty procedure can often be performed with local anesthesia. However, some patients, depending on their general health and severity of the spinal fracture(s) may require general anesthesia.
Patients are able to walk and return to their normal activities soon after surgery.
Kyphoplasty may be performed in an ambulatory surgery center (ASC), hospital, or outpatient spine surgery center.
Most patients are discharged home the same day as their kyphoplasty procedure. An overnight hospital stay may be recommended for some patients depending on many factors, such as coexisting medical problems (eg, cardiovascular risks).
Your doctor will give you specific post-operative instructions, but generally, you will spend about an hour in the recovery room after the procedure. There, a nurse diligently monitors your vital signs, which includes back pain.
Most patients are discharged from the ASC or hospital within 24 hours of their balloon kyphoplasty procedure. At your surgical follow-up appointment, your doctor will assess your recovery progress to determine if you should limit certain activities (eg, lifting). Many patients report significant improvements in pain, mobility and the ability to perform daily tasks—so you may not need to make any adjustments to your physical activity level.
Vertebral compression fractures (VCFs) are a common condition, especially in the elderly population, and are often associated with osteoporosis. Traditional treatments for VCFs include conservative management, such as pain medication and bracing, or surgical interventions such as spinal fusion. However, these treatments may have limited efficacy or lead to other complications. Kyphoplasty balloon vertebral perforator (KBP) is a minimally invasive, breakthrough treatment for VCFs that has revolutionized the management of this condition. In this article, we will explore the mechanism, indications, benefits, and risks associated with KBP.
VCFs occur when the vertebral body collapses due to weakened bone structure, often caused by osteoporosis or trauma. The vertebral body is the central portion of the vertebra, and is composed of cancellous bone surrounded by a thin layer of cortical bone. When the vertebral body collapses, it can result in significant pain and disability.
KBP is indicated for the treatment of painful VCFs that have failed to respond to conservative management, or in cases where surgery is not a suitable option. The procedure is generally well-tolerated and has a low risk of complications.
KBP involves the use of a small balloon catheter that is inserted into the collapsed vertebral body under fluoroscopic guidance. The balloon is then inflated to restore the height of the vertebral body and create a cavity. Once the cavity is created, bone cement is injected to stabilize the vertebral body and prevent further collapse.
KBP has several advantages over traditional treatments for VCFs. Firstly, it is a minimally invasive procedure that can be performed under local anesthesia, reducing the risks associated with general anesthesia. Secondly, it is associated with a shorter hospital stay and quicker recovery time compared to traditional surgery. Finally, KBP has a high success rate, with most patients experiencing significant pain relief and improved function following the procedure.
Like any medical procedure, KBP carries some risks and potential complications. These may include infection, bleeding, nerve damage, cement leakage, or worsening of the fracture. However, the risk of these complications is relatively low, and most patients tolerate the procedure well.
After KBP, patients are typically monitored for a short period and can usually return home the same day. They are advised to avoid heavy lifting and strenuous activity for several weeks, but can typically resume normal daily activities within a few days. Physical therapy may also be recommended to help with rehabilitation.
KBP is a relatively new procedure, and ongoing research is exploring its potential applications and refinements. For example, there is ongoing research into the use of biodegradable bone cement, which could reduce the risk of long-term complications associated with traditional cement.
Kyphoplasty balloon vertebral perforator is a minimally invasive, breakthrough treatment for painful VCFs that has revolutionized the management of this condition. The procedure is generally well-tolerated and has a high success rate, with most patients experiencing significant pain relief and improved function following the procedure. While there are some risks associated with the procedure, these are generally low, and most patients tolerate the procedure well. As ongoing research explores the potential applications and refinements of KBP, this procedure is likely to continue to be an important tool in the management of VCFs.
Is KBP a suitable treatment option for all patients with VCFs?
KBP is indicated for the treatment of painful VCFs that have failed to respond to conservative management or in cases where surgery is not a suitable option. However, not all patients with VCFs are candidates for KBP, and the decision to undergo the procedure should be made in consultation with a healthcare provider.
How long does the KBP procedure take?
The KBP procedure typically takes around one hour to perform.
How soon after the procedure can patients resume normal activities?
Patients can typically resume normal daily activities within a few days after the procedure, although heavy lifting and strenuous activity should be avoided for several weeks.
What are the potential complications associated with KBP?
Potential complications associated with KBP may include infection, bleeding, nerve damage, cement leakage, or worsening of the fracture. However, the risk of these complications is generally low.
Is KBP covered by insurance?
KBP is usually covered by insurance, although coverage may vary depending on the patient's individual insurance plan and other factors.