Complications
Complications in kyphoplasty are very rare (approximately 0.2% per fracture). The main risk is a leakage of bone cement from the vertebral body, which is, however, seen more frequently in vertebroplasty (vertebroplasty approx. 20-70%; kyphoplasty approx.
4-10%). The reason for this is the use of a more fluid bone cement and a higher pressure generation when injecting the bone cement into the vertebral body during vertebroplasty. This is more likely to cause bone cement to escape from the damaged vertebral body.
However, most bone cement leaks are not associated with postoperative discomfort for the patient. Overall, however, vertebroplasty is not a very risky surgical procedure. Serious complications are only described in individual cases. The following complications are described:
- Exit of bone cement into the spinal canal
- Epidural hematoma (post-bleeding)
- Bone cement induced pulmonary embolisms
- Paradoxical cerebral embolisms
- Bold embolism
- Adjacent vertebral body fractures
- Disturbance of the spinal cord during straightening or cementing
Results
For both surgical procedures, kyphoplasty and vertebroplasty, comparably good results regarding pain reduction are given in the research literature. A significant reduction of pain should be achieved in 80-95% of cases with both procedures.The cause of the immediate pain reduction is the internal stabilization of the vertebral body, which reduces micro-movements that cause irritation of nerve fibers of the periosteum (periosteum) of the vertebral body. With regard to the restoration of vertebral body height through kyphoplasty, an average recovery of the measured loss of height of approximately 40-50% is shown.
However, follow-up examinations showed that postoperative height loss of 3-8% can occur within the first 3 months. In addition, the vertebral body height remains constant according to current knowledge. The best results regarding the restoration of vertebral body height are observed in fresh fractures (up to 4 weeks), because there has not yet been any bony development in the malposition
- Very low-risk surgical procedure
- Indication for older and fresh vertebral body sintering with the aim of rebuilding the vertebral body.
- Restoration of vertebral body height using a balloon catheter.
- Vertebral body stabilization with bone cement.
- Risk of cement leakage low due to the previously created cavity and the low filling pressure of the vertebral body with viscous bone cement.
- Rapid, significant pain reduction in 80-95% of patients.
- Immediate mobilization after the operation is possible.
- Low risk surgical procedure.
- Indicated for certain types of vertebral body tumors and older fractures for stabilization without repositioning the vertebral body.
- No restoration of the vertebral body height through a balloon catheter.
- Vertebral body stabilization with bone cement.
- High risk of cement leakage due to the introduction of low-viscosity bone cement under high pressure.
- Rapid, significant pain reduction in 80-95% of patients.
- Immediate mobilization after the operation is possible.
