Balloon Kyphoplasty for Spinal Fractures
Balloon kyphoplasty procedures have been used to treat spinal fractures for a number of years now. My mother has had this procedure twice and it has provided some very positive results. I wanted to provide information about her surgery so that others who are considering it, can learn about her experience.
Certainly, the results of any treatment or surgical procedure can vary by individual and only your physician can determine whether or not it's right for you. The purpose of this page is not to provide scientific evidence or medical advice. However, I will provide some basic information about balloon kyphoplasty, some educational videos that I've found online, and describe my mother's situation on this page.
Photo by msklibrary, Lindsay Davidson.
About Spinal Fractures
Balloon kyphoplasty is indicated in many cases involving spinal fractures.
The spine has 33 vertebral bones. There is softer tissue in between each of these for cushioning. These vertebrae protect your spinal cord/nerves, support your head, chest, and shoulders, and they allow you the flexibility of bending and rotating your upper body. When one or more of these vertebral bones cracks or collapses there can be swelling, pain, and misalignment.
A variety of things can cause a spinal fracture. Osteoporosis is a very common cause of compression fractures. Use of corticosteroids can also weaken bones and result in fractures as well. My mother has osteoporosis and has required steroid treatment for a life threatening condition known as temporal arteritis. Chemo and radiation therapy can also result in a spinal fracture and even hyperthyroidism can have similar results.
These factures sometimes go undetected and can eventually heal on their own. However a dull pain in the back is one common symptom and, at least in my mother's case, a sharper pain in the back when putting pressure on the area can be a symptom. My mother thought perhaps she had a broken rib despite not having fallen. An individual may have a spinal fracture without having experienced a fall or another "major" incident when bones are weakened due to any of the situations described above.
An X-Ray or an MRI is used to make the final diagnosis of a spinal fracture. My mother's surgeon reviewed her X-rays with us. The X-ray showed all of her rectangular-shaped vertebrae, with one which was collapsed, giving it more of a triangular shape. He explained that it would heal on it's own over time, but when it did so, it would remain collapsed and her pain could persist. In addition, her height would continue to decrease each time this happened.
While the loss of height is one negative outcome, it's isn't the only one. For a person who has osteoporosis, the risk of additional compression fractures is great. Over time, the characteristic "Dowagers Hump" develops. In addition, the space in which the stomach, lungs, and other organs reside becomes compressed making eating, breathing, and perhaps bowel and bladder function more difficult. For these reasons, we felt that the balloon kyphoplasty which would help her vertebrae return to their normal uncompressed, rectangular shape, was critical to prevent additional problems.
You can learn a bit more about spinal fractures in the short animated video below.
What Is Balloon Kyphoplasty?
Ballon kyphoplasty is a surgical procedure in which the surgeon creates a space within the fractured vertebra and injects a bone "cement" to return it to it's previous shape/height. It can eliminate pain and help maintain a normal structure.
My mother's balloon kyphoplasty experience was relative quick and was effective in reducing pain and helping to prevent further collapse of her spinal column. She had minimal activity restrictions for a day or two and only small incision sites to care for over the following 10 day period. I will describe her most recent balloon kyphoplasty experience in more detail below but you can find out more about balloon kyphoplasty from the Medtronics site.
How Balloon Kyphoplasty Works
My Mother's First Experience with Balloon Kyphoplasty
Back in the fall of 2005 my mother was in the hospital for back pain and excessive weight loss. She had moved a couple of years prior to this and refused to get a new physician. In 2004, she began experiencing a great deal of back pain and after spending much of her time that year immobile and losing 10-15lbs off of her 89lb frame, I coerced her into going to the hospital. At that point she had become depressed and experienced a sense of hopelessness.
Among other things, it was discovered that she had a recent compression fracture as well as some older ones that had already healed. She had been diagnosed with osteoporosis more than 10 years prior to this.
The orthopaedic surgeon brought in to consult on her, performed balloon kyphoplasty at that time. She was discharged the same day. She had no restrictions following the surgery. In her case, her pain was improved but still present due to the fact that she had severe arthritis in her back as well. However, using a single dose of hydrocodone at night she was able to effectively manage that pain. Her mobility returned and her mood improved significantly.
Overall, we felt the outcome of the balloon kyphoplasty was very positive.
Unfortunately, my mother regained little of her lost weight, but this was probably due primarily to unrelated gastrointestinal issues that were developing.
A Second Balloon Kyphoplasty Experience
Fast forward to 2011. My mother was now 83 years old and weighed only 78lbs fully clothed. She had begun complaining about "light headedness", a feeling of fullness after eating only a few bites, shortness of breath with minimal exertion, and a sharp pain in her back near her ribs on one side. When I weighed her, she had lost a few pounds, which at her size, is significant. For the past four years, she had been taking an injectable bisphosphonate (Reclast) annually for her osteoporosis.
I took her to the doctor and tests were ordered. Of course GI issues explained some of her symptoms but again, a recent compression fracture was found. Because of an earlier diagnosis of Temporal Arteritis, my mother had been taking Prednisone (a steroid). Although this treatment was critical and life saving, it likely caused additional damage to her bones despite her Reclast injections. Once additional testing related to her other symptoms was completed, she was scheduled for another balloon kyphoplasty. By the time of the surgery, she weighed only 67lbs.
The day before the surgery, pre-surgery bloodwork, an EKG, and so forth were completed, but took only 20 minutes of our time. The surgery the next day was performed as an Outpatient. She was scheduled for the procedure at 12:30 p.m. but we had to arrive by 10:00 a.m. to get all of the intake information done. An IV line was placed and we met briefly with the anesthesiologist. A breathing treatment was administered since my mother has COPD.
My mother was in the surgery suite for an hour and a half. My understanding is that a fair amount of the time was spent getting her set up, under anesthesia, and then also waiting for the "cement" to dry. She was in recovery for approximately an hour, including the time it took us to get her dressed and ready to return home.
She wore compression socks during the surgery and for the remainder of that day to avoid blood clots. She was able to take the brief ride in the car home and to walk to her bedroom with me standing by to keep her stable. She was a bit "wobbly" for the first few hours. After that, she seemed to be back to normal and had minimal restrictions.
Her physician instructions required her to avoid any significant lifting or pulling for a few days and she had stitches to close up the two small incisions on each side of her spine. She had to have an over-the-counter antibiotic cream applied daily with a bandage to help them heal and prevent infection. She also had a twice-a-day oral antibiotic and prn pain medication. She required the pain medication for only the first day or two.
Within four or five days, my mother gained back 4lbs. I assume this is due in large part to the absence of pain. It is now three weeks since her surgery and my mother has continued to gain weight. She is pain free, still taking a single hydrocodone tablet in the PM due to arthritis. She has also been taking Megestrol Acetate to increase her appetite. She now weighs 74lbs, up from 67lbs.
Her follow up visit with the surgeon was scheduled 10 days after the date of the procedure for the purpose of removing her stitches.
It's only been a week since my mother's second balloon kyphoplasty, but we are hoping that her issues with high blood pressure may also resolve thanks to this procedure. My mother had always had low blood pressure but in the past month or two, we had seen it rise to dangerous levels. It is now controlled with medication but her internist indicated that her compression fracture and pain may have caused it to rise. She will be monitored over the coming months to see if her blood pressure returns it's normal level. I'll update this page with the results.
Osteoporosis and Balloon Kyphoplasty Resources
Medtronics provides equipment/supplies for balloon kyphoplasty. Their site provides an overview of the procedure.
- Mayo Clinic
The Mayo Clinic site provides information about Osteoporosis and the medications used to treat it.
- Medline Plus
This webpage can provide information about symptoms of compression fractures and potential treatments
Tips for preventing osteoporosis