Indications For Kyphoplasty

Indications for kyphoplasty include continued, unrelenting pain (more than four to six weeks) following an identified vertebral compression fracture. Identifying the appropriate pain generator in the presence of multiple compression fractures of differing ages can be a challenging endeavor. This requires a careful physical examination and scrutiny of selected imaging modalities. The use of magnetic resonance imaging, computed tomography scanning, and nuclear medicine scanning offers additional information to plain radiography in determining the acute-ness of a fracture or fractures (Fig. 2). Some authors have recommended the use of vertebroplasty and kyphoplasty in fractures less than four to six weeks of age. Intervention in this setting is

FIGURE 2 Post-kyphoplasty lateral plain radiograph of the thoracolumbar spine in an elderly female with multiple compression fractures. The painful vertebral compression fracture (pain generator) was properly identified preoperatively to be at the T12 level by physical examination, plain radiography, and magnetic resonance imaging.

FIGURE 2 Post-kyphoplasty lateral plain radiograph of the thoracolumbar spine in an elderly female with multiple compression fractures. The painful vertebral compression fracture (pain generator) was properly identified preoperatively to be at the T12 level by physical examination, plain radiography, and magnetic resonance imaging.

predicated on the failure to improve, following two to three weeks of conservative measures in the setting of intense unrelenting pain. Other indications for kyphoplasty include prophylactic augmentation of noncompressed osteopenic levels adjacent to an instrumented fusion in osteo-porotic patients, and anterior column support of an osteoporotic vertebral body following a posterior decompression.

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Dealing With Back Pain

Dealing With Back Pain

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