Spine Augmentation

The Division of Interventional Radiology is proud to provide spine augmentation services, including kyphoplasty and radiofrequency ablation, for treatment of painful pathologic spine fractures for the Southcoast Hospital System.

Introduction to Pathologic Spine Fractures

A pathologic fracture is a broken bone that occurs due to an underlying process that weakens the bone and makes it susceptible to injury.
Osteoporosis (low bone density) and bone tumors are the two most common conditions that are associated with pathologic spine fractures.
The following is an overview of the spine augmentation services that are provided by the interventional radiologists for the Southcoast Hospital System, including kyphoplasty and radiofrequency (RF) ablation.

What is an Interventional Radiologist? (learn more)

Interventional Radiologists (IR doctors) are physicians who perform minimally-invasive procedures in nearly every organ system of the body using ultrasound, x-ray, CT, or MRI guidance.
By performing procedures in the least invasive way possible, interventional radiologists can diagnose, treat, and even cure disease while minimizing the risk to the patient and improving health outcomes with less pain and shorter recovery times in comparison to open surgery.
Most procedures can be performed without general anesthesia or admission to the hospital.

Pathologic Spine Fracture Treatment Options

Medical management is the preferred treatment option as long as there is adequate pain control.
However, if pain cannot be controlled with medication, kyphoplasty should be considered.
If a pathologic fracture is associated with an underlying bone tumor, kyphoplasty is often combined with radiofrequency (RF) ablation, which destroys the tumor by heating it.
Radiation therapy is another treatment option that can be combined with kyphoplasty and RF ablation.
Severe fractures with associated spinal cord or nerve impingement may require open surgery.

What is Kyphoplasty and how is it performed?

Kyphoplasty is a minimally-invasive image-guided procedure for treatment of painful pathologic spine fractures that are resistant to medical therapy.
The procedure itself is not significantly painful and is typically performed with sedation medicine rather than general anesthesia (no breathing tube).
The procedure is performed by inserting 1-2 small access needles through the skin and into the bone under x-ray guidance, which only requires a tiny hole in the skin measuring about 5 mm in diameter.
The remainder of the procedure is then performed through the access needle, which often includes a bone biopsy, inflation of a small balloon to restore the bone height that was lost due to the fracture, and injection of bone cement that stabilizes the fracture and helps to improve pain.
RF ablation can also be performed through the access needle if there is an associated bone tumor.

How effective is Kyphoplasty?

Most patients experience immediate pain relief following kyphoplasty.
Others will gradually experience pain relief over the next several days.
It is very uncommon for patients to not experience some form of pain relief.

What is required before Kyphoplasty can be performed?

Prior to kyphoplasty, patients need to be evaluated by an interventional radiologist to confirm that they are an appropriate candidate.
Patients also require an MRI or a nuclear medicine bone scan to confirm the acuity of their fracture.
Some patients will also need to be evaluated by a neurosurgeon if there is evidence of spinal cord or nerve compression.

Is Kyphoplasty safe and what are the risks?

Kyphoplasty is a relatively safe procedure with a low complication rate.
It is especially beneficial in the elderly and in patients with multiple medical problems as they can return to their baseline level of functioning sooner than if they were to continue with medical management, which could result in prolonged bedrest and increase their risk of developing pneumonia, deconditioning, and blood clots.
The risks of the procedure include bleeding, infection, and cement leakage outside of the bone.
There is also a low but serious risk of spinal cord compression and nerve injury.

Recovery and follow-up after Kyphoplasty

Patients must lay flat for one hour after the procedure
Then they can sit upright and even begin walking.
Out-patients are observed in recovery for at least two hours and then discharged home.
In-patients can be discharged once they are cleared by the doctor that is caring for them.
Patients have follow-up x-rays and are evaluated in the IR clinic 4-weeks after the procedure.