Kyphoplasty is a procedure used to relieve pain associated with a compression fracture of a spine bone, or vertebra. With vertebral compression fractures, the bone collapses on itself. Kyphoplasty uses a balloon-like device to create a cavity within the fractured vertebra, restoring its height. Bone cement is injected into the cavity to hold the bone fragments in place. Kyphoplasty proves safe and effective for many, but not all, patients. Contraindications to kyphoplasty include conditions for which the risks outweigh the potential benefits of the procedure.
Bleeding Disorders
Kyphoplasty involves the use of metal tubes inserted into the vertebra, in close proximity to the spinal cord. Among people with a blood clotting abnormality, kyphoplasty can cause serious bleeding, report Dr. Ryan Halpin and colleagues in a 2004 article published in the "Journal of Supportive Oncology." For this reason, a bleeding disorder is usually a contraindication to kyphoplasty.
Pregnancy
Kyphoplasty is a nonurgent, elective procedure. As with other elective surgical procedures, kyphoplasty is not recommended for pregnant women. Women who have an indication for kyphoplasty may elect to undergo the procedure after delivery.
Active Infection
Active infection of the vertebra or intervertebral disc and generalized infections are contraindications to the use of kyphoplasty for a vertebral compression fracture, notes the University of Pittsburgh Medical Center. Patients may be reevaluated for kyphoplasty, if appropriate, once the infection has cleared.
Allergy to Bone Cement
People with an allergy to polymethylmethacrylate, the bone cement used in kyphoplasty, cannot undergo the procedure, reports orthopedic surgeon Vincenzo Denaro in a 2009 review article published in the medical journal "Clinical Cases in Mineral and Bone Metabolism."
Spinal Cord Compression
Some vertebral compression fractures force pieces of the bone toward the spinal cord, causing compression. Neurological symptoms, such as radiating pain and muscular weakness, frequently occur with spinal cord compression. The presence of symptomatic spinal cord compression is a contraindication to kyphoplasty due to the risk for permanent spinal cord injury, states the International Association for the Study of Pain. Patients with spinal cord compression often require another form of surgical treatment for their condition.
Lack of Symptoms or Symptom Improvement
Vertebral compression fractures most commonly occur because of bone weakness associated with osteoporosis, reports the University of Pittsburgh Medical Center. An osteoporosis-related vertebral compression fracture may cause few or no symptoms. Among those who develop symptoms, pain usually improves over a period of days to weeks, reports the American Association of Neurological Surgeons. For patients without symptoms and those experiencing resolution of their pain with time and noninvasive therapy, kyphoplasty is contraindicated. Because the procedure involves risks, kyphoplasty is reserved for patients with severe pain who do not experience improvement with noninvasive treatment, such as rest, bracing and pain-relieving medication.
References
- "Journal of Supportive Oncology"; Minimally Invasive Treatments for Spinal Metastases: Vertebroplasty, Kyphoplasty, and Radiofrequency Ablation; Ryan J. Halpin, B.S., et al.; July-August 2004
- University of Pittsburgh Medical Center: Vertebroplasty and Kyphoplasty
- "Clinical Cases in Mineral and Bone Metabolism"; Vertebroplasty and Kyphoplasty; Vincenzo Denaro, M.D., et al.; May-August 2009
- International Association for the Study of Pain: Vertebroplasty and Kyphoplasty for Cancer Pain
- University of Pittsburgh Medical Center: Vertebral Compression Fracture
