Kifoplasty is a minimally invasive method for treating a damaged spine. In addition, kyphoplasty was developed to treat such problems of the spine as separation and weakening of the bone material of vertebral bodies.
Often the cause of these fractures is osteoporosis. In recent years, the methods of Cytoplasty and Vertebroplasty have acquired a completely different meaning in medicine. Earlier, to correct compression fractures of the vertebrae that appeared due to osteoporosis, surgeons used a standard open operation.
Operations of future in case of back pain
Vertebroplasty and kyphoplasty are two new procedures used for acute compression fractures in the vertebrae that produce severe back pain that does not lend itself to narcotic analgesics. Using a fluoroscope for visual observation, the surgeon injects bone cement into the vertebra. It supports the damaged vertebra and alleviates the pain. But complications are not excluded: for example, if you do not calculate the force of pressure, you can destroy the thin wall of the vertebra. In addition, pain in the leg may appear, and you may have to remove the injected substance.
With kyphoplasty, a tube with a ball at the end is inserted into the vertebral body through the needle. This balloon is inflated, and the body of the vertebra recovers its shape. The ball is extracted, and cement is injected into the interior at low pressure. With this procedure, the risk of cement entering the spinal canal from the vertebra is reduced.
Stages of kyphoplasty:
a - kyfobalon, appearance
b - compression fracture of the vertebral body
c - administration of kyvoballon
d - expansion of the cioballon and formation of the cavity in the body of the vertebra
e - filling the cavity with bone cement
f - the end result
Kifoplasty in a short time facilitates the pain associated with orthopedic disorders. This operation is successful if it is performed within 6 weeks after the onset of the disorder.
Kypoplasty is a new minimally invasive surgical procedure designed to treat patients with compression fractures of the spine, accompanied by pain syndrome. This operation is performed through a puncture of the skin (does not require surgical incisions) under local anesthesia. The duration of kyphoplasty averages 35-60 minutes. After such an operation, the patient can be discharged from the hospital on the same day!
· stop or significantly reduce back pain
· prevent further "subsidence" of the fractured vertebra, which contributes to cessation of progression of the spinal deformity and related problems in the long-term period
· To restore physiological curves of the spine and maintain normal posture
When is kyphoplasty prescribed?
Kifoplasty should be considered as the operation of choice (the best possible) for the treatment of patients with back pain and deformity of the vertebra as a result of a pathological compression fracture. Most patients with compression fractures of the spine have a decrease in bone density ("dilute bone") as a result of osteoporosis. In most cases, this disease affects older women. The development of osteoporosis is facilitated by the prolonged intake of certain medications (steroids), certain diseases of the kidneys and liver, and the asthenic type of constitution.
In more rare cases, a compression fracture of the spine may result from the destruction of the vertebral body of a malignant or benign (hemangioma) tumor.
In patients with osteoporosis or tumor lesion of the vertebra, fracture can occur with minimal trauma (fall from the height of human growth or even a simple tilt or turn of the trunk).
In young healthy people who have normal bone density, compression fracture of the vertebra can occur only as a result of a serious injury, for example, falling from a high altitude or a car accident. In such patients, kyphoplasty is not indicated, since the risk of progressive vertebral deformity during the consolidation period of the fracture is negligible, and surgical intervention can be complicated by technical difficulties. Such patients are treated conservatively or, in the presence of indications, they may be offered a different type of surgical intervention.
The technique of kyphoplasty surgery
During surgery, the patient is positioned on the operating table in the abdominal position. In the operating room, monitoring (control) of the function of the vital organs of the patient is performed, intravenous sedatives (soothing) and anesthetics are administered. The operation is performed with constant radiological monitoring, so the probability of trauma to the nerve structures and internal organs is negligible. After processing the operating field, a thin metal tube-conductor is inserted directly into the body of the fractured vertebra.
After this, the surgeon carries a special balloon through the tube, which is then filled with fluid under pressure. As a result, the geometry of the broken vertebra is restored, and a cavity is formed inside its body. After that, the balloon is blown off and extracted from the tube-conductor. The resulting cavity is filled with a thick bone cement, which after a few minutes hardens. The introduction of cement leads to internal stabilization of the vertebra, which reduces the risk of developing compression fractures in the future.
a, b - introduction of kyfoballon
c - expansion of kyzoballone with X-ray contrast substance
d - filling the cavity with bone cement
After kyphoplasty surgery
You can sit down and get up 2 hours after the operation. Your doctor may recommend wearing a light corset for several weeks after surgery. 2 weeks after surgery, physical exercises are allowed to strengthen the muscles of the back and abdominals.
Results of kyphoplasty surgery
As a result of clinical studies, it is shown that in 90% of patients with compression fracture of the spine in the presence of osteoporosis, back pain is significantly reduced or occurs immediately or within 2 weeks after kyphoplasty. In 70-90% of patients, the normal height of the fractured vertebra is almost completely restored.
a - compression fracture of the vertebral body L1
b - postoperative radiograph
c - postoperative computer tomogram
Operation of vertebroplasty
The operation of vertebroplasty is aimed at strengthening the damaged vertebral body with a special plastic or bone cement. It is performed with compression fractures of vertebral bodies without compression of the nervous structures. Most often, such fractures occur with osteoporosis (rarefaction of bone tissue), trauma, hemangioma, metastases in the vertebrae and other tumors of the spine. The introduction of plastic into the vertebra is carried out through a special needle under the control of a special X-ray machine. The procedure is performed under local anesthesia without anesthesia. Often, it is the only method of treatment in elderly patients who can not perform stabilization of the spine. Within 2-3 hours after the intervention the patient can start walking.