A. The average cost of Vertebroplasty & Kyphoplasty in India starts from $5,000 to $8,000. The cost can be less or more depending on several factors including your medical condition, surgeon practice and hospital location.
Vertebroplasty and kyphoplasty are minimally invasive procedures for the treatment of painful vertebral compression fractures (VCF), which are fractures involving the vertebral bodies that make up the spinal column.
When a vertebral body fractures, the usual rectangular shape of the bone becomes compressed, causing pain. These compression fractures may involve the collapse of one or more vertebrae in the spine and are a common result of osteoporosis. Osteoporosis is a disease that results in a loss of normal bone density, mass and strength, leading to a condition in which bones become increasingly porous, and vulnerable to breaking easily. Vertebrae may also become weakened by cancer.
For a vertebroplasty, physicians use image guidance, typically fluoroscopy, to inject a cement mixture into the fractured bone through a hollow needle. During kyphoplasty, a balloon is first inserted into the fractured bone through the hollow needle to create a cavity or space. The cement is injected into the cavity once the balloon is removed.
Your Surgeon may recommend a vertebroplasty & Kyphoplasty to treat vertebral compression fractures in your spine. Vertebral compression fractures occur when your vertebral bones become weak.
Your doctor may recommend vertebroplasty to treat the following conditions:
These procedures can be effective in treating people whose bones are weakened by cancer or whose vertebrae collapse due to osteoporosis, a disease that causes loss of bone density.
Kyphoplasty and vertebroplasty are used to mend recent fractures. However, they aren’t used as a preventive technique, even for osteoporosis. As well, they’re usually not advised for herniated disks, back arthritis, or curvature of the spine due to scoliosis.
These two procedures haven’t been extensively tested in younger, otherwise healthy people. The long-term effects of the bone cement aren’t known, so these procedures are generally reserved for older people.
It is important to correctly assess a patient who presents with spinal pain of traumatic or atraumatic origin that is not responding to conservative treatment, particularly if the patient falls under the risk category for osteoporosis. The most common tests are:
Radiography – X-rays are usually the first diagnostic test performed as they are inexpensive. A lateral X-ray of the thoracic or lumbar spine can often identify a fracture and reveal any loss of height or misalignment of the spine.
Computed Tomography (CT) scan – provides greater detail of bony anatomy and can reveal loss of height, fragment retropulsion, and any compromise of the spinal.
Magnetic Resonance Imaging (MRI) – This is more expensive but can reveal whether the fracture is acute (by the presence of bony oedema) and also if there is compromise of the neurological system.
Bone Scintigraphy – a nuclear medicine imaging technique of the bone that is used to diagnose bone conditions and disorders such as fracture, infection, and cancer.
You can gather information and read-up about the discectomy procedure during this preparative period. In case of any doubts, you should talk to the surgeon, Once a decision is made to go for the Vertebroplasty & Kyphoplasty Procedure.
The surgeon may carry out a thorough physical examination to assess that the patient is in the healthy condition to have the surgery.
The surgeon will ensure the state of health of the patient and rule out any chronic underlying diseases through blood and urine analysis.
If the patient is a smoker, smoking should be stopped several days before the surgery or quit altogether.
Certain medications such as warfarin and/or aspirin that the patient may be taking will be stopped by the surgeon approximately 2 weeks prior to the surgery. These medications increase the risk of bleeding during surgery.
The patient will be evaluated with the results of these investigations by the cardiologist and anesthetist and pronounced fit for surgery provided there are no serious problems.
The patient should be on an empty stomach since midnight the previous night.
The patient is provided a clean surgical gown to wear and taken to the operation theater.
Image-guided, minimally invasive procedures such as vertebroplasty and kyphoplasty are most often performed by a specially trained interventional radiologist or neuroradiologist in an interventional radiology or neuroradiology suite, or occasionally in the operating room.
This procedure is often done on an outpatient basis. However, some patients may require admission following the procedure. Ask your doctor if you will need to be admitted.
You may be connected to monitors that track your heart rate, blood pressure, oxygen level and pulse.
A nurse or technologist will insert an intravenous (IV) line into a vein in your hand or arm to administer a sedative. This procedure may use moderate sedation. It does not require a breathing tube. However, some patients may require general anesthesia.
You may be given medications to help prevent nausea and pain, and antibiotics to help prevent infection.
You will be positioned lying face down for the procedure.
The area through which the hollow needle, or trocar, will be inserted will be shaved, sterilized with a cleaning solution and covered with a surgical drape.
A local anesthetic is then injected into the skin and deep tissues, near the fracture.
A very small skin incision is made at the site.
Using x-ray guidance, the trocar is passed through the spinal muscles until its tip is precisely positioned within the fractured vertebra.
In vertebroplasty, the orthopedic cement is then injected. Medical-grade cement hardens quickly, typically within 20 minutes. The trocar is removed after the cement is injected.
In kyphoplasty, the balloon tamp is first inserted through the needle and the balloon is inflated, to create a hole or cavity. The balloon is then removed and the bone cement is injected into the cavity created by the balloon.
X-rays and/or a CT scan may be performed at the end of the procedure to check the distribution of the cement.
Pressure is applied to prevent any bleeding and the opening in the skin is covered with a bandage. No sutures are necessary.
This procedure is usually completed within one hour. It may take longer if more than one vertebral body level is being treated.
Devices to monitor your heart rate and blood pressure will be attached to your body.
You will feel a slight pinch when the needle is inserted into your vein for the IV line and when the local anesthetic is injected. Most of the sensation is at the skin incision site. This is numbed using local anesthetic. You may feel pressure when the catheter is inserted into the vein or artery. However, you will not feel serious discomfort.
If the procedure is done with sedation, the intravenous (IV) sedative will make you feel relaxed, sleepy and comfortable for the procedure. You may or may not remain awake, depending on how deeply you are sedated.
The treatment area of your back will be cleaned, shaved and numbed.
During the procedure you will be asked questions related to your comfort. It is important for you to be able to tell your doctor whether you are feeling any pain.
The longest part of vertebroplasty and kyphoplasty procedures involves setting up the equipment and making sure the needle is perfectly positioned in the collapsed vertebral body.
You may feel a tapping sensation during the procedure as the trocar is advanced into the bone.
You may not drive after the procedure, but you may be driven home if you live close by. Otherwise, an overnight stay at a nearby hotel is advised.
You will be advised to increase your activity gradually and resume all your regular medications. At home, patients may return to their normal daily activities, although strenuous exertion, such as heavy lifting, should be avoided for at least six weeks.
If you take blood thinners, check with your doctor about restarting this medication the day after your procedure.
Pain relief is immediate for some patients. In others, pain is eliminated or reduced within two days. Pain resulting from the procedure will typically diminish within two to three days.
For two or three days afterward, you may feel a bit sore at the point of the needle insertion. You can use an icepack to relieve any discomfort but be sure to protect your skin from the ice with a cloth and ice the area for only 15 minutes per hour. Your bandage should remain in place for 48 hours. Do not immerse the bandage in water for 48 hours. This is to prevent infection. Taking showers is allowed.
You will spend time in a recovery room. You could go home the same day, but your doctor may want you to stay overnight.
It’s possible that you can start walking an hour after the procedure. You may feel some soreness where the needle entered your back, but this lasts no more than a few days. You may quickly notice that you have less pain than you did before the surgery.
Talk with your doctor about whether you should avoid any activities after the procedure.
Your doctor may suggest taking certain vitamins, minerals and medications to help strengthen your bones and prevent additional spinal fractures.
Q. Is vertebroplasty procedure painful?
A. You may experience pain relief almost immediately after the procedure, but it might take up to 72 hours. Your doctor can provide you with over-the-counter pain relievers for the temporary discomfort. Your doctor will assess your pain and check for any possible complications
Q.Is vertebroplasty a major surgery?
A. The goal of a vertebroplasty procedure is to stabilize the vertebral compression fracture to stop its painful movements. Vertebroplasty is considered a minimally invasive surgery because it is done through a small puncture in the skin instead of an open incision.
Q. Which is better vertebroplasty or kyphoplasty?
A. Compared with medical therapy, kyphoplasty was superior for improving both pain and patient function, whereas vertebroplasty improved patient function but not pain
Q. How long does it take to recover from kyphoplasty surgery?
A. Pain relief will be immediate for some patients. In others, elimination or reduction of pain is reported within two days. At home, patients can return to their normal daily activities, although strenuous exertion, such as heavy lifting, should be avoided for at least six weeks.