Balloon Kyphoplasty Procedure: A Personal Experience
Balloon Kyphoplasty for Spinal Fractures
Balloon kyphoplasty procedures have been used to treat spinal fractures for many years now. My mother had this procedure twice, and it provided some very positive results. I wanted to provide information about her surgery so that others who are considering it can learn about it from her experience.
When you read about my mother's second kyphoplasty experience, you will see that even frail individuals with multiple medical issues can typically undergo the procedure.
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 article is not to provide scientific evidence or medical advice. However, I will provide some basic information about:
- spinal fractures
- when balloon kyphoplasty can be useful
- what the procedure entails including some educational videos that I've found
- my mother's experience including preparation, recovery, and results
Common Causes and Symptoms of 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.
- Hyperthyroidism can have similar results.
- Some types of cancer such as lymphoma and multiple myeloma can also greatly increase the risk of spinal fractures.
These fractures sometimes go undetected and can eventually heal on their own. However, a dull pain in the back is one common symptom and in my mother's case, a sharper pain in the back when putting pressure on the area can also be a symptom. It's important to realize that 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.
Aside from pain in your back, other symptoms include:
- Loss of height
- Curved spine
- Difficulty bending and twisting
Diagnosis and Possible Outcomes of Spinal Fractures
An X-Ray, CT scan, 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-rays showed all of her rectangular-shaped vertebrae, with the exception of one which was collapsed, giving it more of a triangular shape. He explained that it would heal on its own over time, but once healed, it would remain collapsed, and her pain could persist. In addition, her height would continue to decrease each time this happened.
In fact, untreated spinal fractures can potentially result in a variety of negative outcomes including:
- Loss of height with the development of the characteristic "Dowagers Hump"
- Compression of space in which the stomach, lungs, and other organs reside potentially resulting in:
- Loss of appetite
- Decreased lung capacity
- Impaired bowel and bladder function
- Decreased activity due to pain and difficulty moving
- Additional fractures due to further weakening as a result of inactivity
- Disturbed sleep pattern due to pain
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.
An Overview of Compression Fractures and Treatments
What Is Balloon Kyphoplasty?
Balloon 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 its previous shape/height. It can eliminate pain and help maintain a normal structure.
My mother's balloon kyphoplasty experience was relatively 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 experiences in more detail below, but you can find out more about balloon kyphoplasty from the Medtronics site.
How Balloon Kyphoplasty Works
A First Experience With Balloon Kyphoplasty With an Elderly but Medically Stable Patient
A decade ago, my mother, who had osteoporosis, 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. For nearly a year, she experienced a great deal of back pain, and after spending much of her time that year immobile and losing 10lbs 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.
It was discovered that she had a recent compression fracture as well as some older ones that had already healed. The orthopedic surgeon brought in to consult with her physician on her case while in the hospital, performed balloon kyphoplasty at that time.
- She had no specific preparation for the procedure and she was discharged the same day.
- My mother was transported from her hospital room, taken to surgery, and returned about an hour and a half later.
- She was discharged from the hospital immediately following her balloon kyphoplasty. She was able to ride in the car and her only restrictions were to avoid lifting. She had small bandages she needed to change for a few days.
- In my mother's 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 to unrelated gastrointestinal issues that were developing.
A Second Balloon Kyphoplasty Experience With a Medically Involved Patient
Fast forward 6 years. My mother was now 83 years old and weighed only 78lbs fully clothed. She had begun complaining about "lightheadedness", 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 was 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.
- Because of her somewhat fragile state, pre-surgery bloodwork and an EKG were completed the day prior to the procedure. However, this 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 had 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. To avoid blood clots, she wore compression socks during the surgery. She was in recovery for approximately an hour, including the time it took us to get her dressed and ready to return home.
- My mother was ordered to continue wearing compression socks the remainder of that day. She was able to take the brief car ride 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. She had stitches to close up the two small incisions on each side of her spine and 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 as needed pain medication. She required the pain medication for only the first day or two.
My mothers follow up visit with the surgeon was scheduled 10 days after the date of the procedure for the purpose of removing her stitches.
- Within four or five days, my mother gained back 4lbs. I assume this was due in large part to the absence of pain. Three weeks post surgery she had continued to gain weight, adding 5 more pounds although she had also been given Megestrol Acetate to increase her appetite as well.
- In addition, my mother was now pain-free, still taking a single hydrocodone tablet in the PM due to arthritis.
Following the procedure, we also witnessed improvement in my mother's blood pressure as well. Although her blood pressure had always been low in the past, in recent months, it had risen to dangerous levels. She was on medication to control it prior to her balloon kyphoplasty, but her internist indicated that her compression fracture, and pain may have caused it to rise. After her surgery, she was able to discontinue the blood pressure medication.
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
Questions & Answers
© 2011 Ruth Coffee