Vertebroplasty and kyphoplasty are considerably less invasive techniques to strengthen the vertebral body compared to the old methods. Compression fractures of the spine are more common in patients with osteoporosis (bone loss). When the spine is under pressure, it breaks and collapses. This causes height loss. This loss of height bends the spine forward and causes a humpbacked appearance called kyphosis. These patients' pain that does not go away for a long time, irregularity in intestinal functions, disruption in sleep patterns, lung problems cause serious decreases in the quality of life.

 

In vertebroplasty, polymethylmethacrylate (colloquially called bone cement) is injected into the vertebral body from the outside with a thick needle only through the skin. During the procedure, the place where the cement is filled, the spinal cord and nerve canals, and the presence of leakage with the veins are checked with radiological imaging, which we call scopy. In kyphoplasty, the broken vertebra is entered with a needle. Then, another cannula with a balloon at the tip is inserted into this fractured vertebra and the balloon is inflated. The balloon re-raises the collapsed vertebra. Then, cement is injected into this area opened by the balloon. Today, the most common use is for osteoporotic vertebral fractures. However, in the oil-suppressed magnetic resonance imaging taken for this procedure, it can be decided whether the fracture is new and the edema. Edema is usually seen on MRI in the first 6-8 weeks after the fracture, which helps to reduce the pain after kyphoplasty. The indication is limited in fractures that exceed 8 weeks.

 

Osteoporosis is a very common health problem all over the world and in our country. The annual incidence of spinal fractures in the United States is approximately 700,000. In a vertebral fracture, the risk of fracture in another vertebra is approximately 20% in the first year. With these methods, it has been possible to treat such fractures without the need for open surgery.

 

Unlike the large surgical incisions and large surgical instrumentation used in open surgery, kyphoplasty is performed with small incisions. It is a safer method for elderly patients who cannot receive general anesthesia and whose general condition is impaired. Infection, bleeding, and limitation of movement secondary to surgery for a long time are almost non-existent with these methods. Thromboembolism, lung problems, bedsores, long-term drug use and corset use are avoided due to prolonged lying down. Kyphoplasty and vertebroplasty can be used effectively in osteoporosis, traumatic fractures, hemangiomas, and vertebral fractures due to tumors. However, like any procedure, this procedure has complications. This given cement is hot and gives off heat around it as it hardens. As a result of escaping of cement from the fracture lines on the back wall of the spine body or from the route of administration to the spinal canal and nerve root canals, it can cause both compression in the spinal cord and nerve and cause burns in the nerve tissues and cause neurological deterioration that is difficult to recover from. Very rarely, cement can escape to the lungs and brain via veins. There is a very low risk of death in serious leaks. However, these conditions are lower when compared to surgical complications.

 

Postoperative pain relief of patients is based on mechanical, heat dissipation, burning of pain nerve endings and chemical causes. In these ways, mechanical stabilization is thought to be the most important cause of pain relief.