Breakthrough Treatment and Technology
Kyphoplasty, Vertebroplasty, and Sacroplasty
Percutaneous Treatment of Spinal Compression Fractures
Department of Radiology and Biomedical Imaging
University of California, San Francisco
San Francisco, California
Kyphoplasty, vertebroplasty, and sacroplasty are percutaneous, or minimally invasive, procedures used to treat painful spinal compression fractures. A compression fracture may cause one or more bones in the spine to become misshapen when external forces cause bone to collapse, crack, or break, further aggravating pain. The term percutaneous means through the skin and is unlike surgery that requires a large incision.
- Kyphoplasty uses imaging to guide the insertion of a balloon into the fractured bone. The balloon is gently inflated to create a cavity into which stabilizing cement is injected. The cavity that is created helps to prevent cement from leaking into surrounding tissue.
- Vertebroplasty and Sacroplasty are also image-guided procedures that use cement to stabilize spinal compression fractures, except these technologies do not employ the use of a balloon.
- Sacroplasty is a treatment for sacral fractures. Sacral refers to the sacrum; the triangular-shaped bone behind your pelvis, at the bottom of the spine.
During each of these procedures, a biologically safe type of cement is injected into the fractured bone. The cement quickly sets and stabilizes the fracture and reduces pain.
Unlike other centers where these procedures are performed using only x-ray fluoroscopy, neuroradiologists at UCSF Precision Spine Center use both CT and x-ray fluoroscopy for optimal guidance.
Kyphoplasty, vertebroplasty, and sacroplasty are performed at the UCSF Precision Spine Center's state of the art image-guided intervention facility. Our doctors and professional staff work together to maximize your safety and comfort.
Our neuroradiologists use CT to first map a pathway for precise placement of needles and cement into the spinal fracture. CT and fluoroscopy (real time x-ray) are utilized during your procedure. The combined use of these modalities provides optimal three-dimensional and real time image-guidance to make your procedure safer and more precise.
Thousands of patients in the United States suffer painful spinal compression fractures. Most result from osteoporosis-related aging, steroid use, multiple myeloma, chemotherapy, or other conditions or treatments that reduce bone mass (bone strength).
It is not uncommon for a patient with a spinal fracture to suffer extreme pain and be bedridden. Conventional nonsurgical treatments such as narcotic pain control, bed rest, and bracing may prove to be inadequate. Kyphoplasty, vertebroplasty, or sacroplasty are cement augmentation (inject cement) techniques that create an internal cast for the fracture, which stabilizes (stops) movement at the fracture site, thereby reducing pain and promoting healing.
Advantages and Possible Risks
- The UCSF Precision Spine Center has a dedicated C-arm fluoroscopy unit and 64-slice scanner that is used together. Our neuroradiologists visualize both bone and soft tissue during your procedure, which improves safety and allows the precise delivery of stabilizing cement.
- Kyphoplasty, vertebroplasty, and sacroplasty are minimally invasive (percutaneous) pain management treatments for spinal fractures and tumors that can significantly improve patient quality of life.
- As with any procedure, patient selection is critical. Best outcomes are seen in patients with a recent fracture(s), certain malignancies - such as multiple myeloma, and suitable anatomy.
- In cases of malignant fractures, our neuroradiologists are experts at using coblation, a technology that allows removal of tumor tissue without dangerous heating, to increase the safety of cement injection.
Any procedure presents a possible risk. However, the primary risks associated with kyphoplasty, vertebroplasty, and sacroplasty (percutaneous augmentation procedures) are related to allergic or adverse reactions from conscious sedation, infection, and bleeding. Although rare, other potential complications include stroke and paralysis.
How Long Does the Procedure Take?
Kyphoplasty, vertebroplasty, and sacroplasty are performed under conscious sedation with local anesthesia, making it safe for a variety of patients. The procedure takes 1-2 hours and patients are discharged the same day.
Answers to questions many patients often ask are provided in the UCSF Precision Spine Center's Pretreatment Patient Guide and the Discharge Instructions and Home Care Patient Guide. Of course, we welcome your questions and look forward to providing you with exceptional care before, during, and after your procedure.