Kyphoplasty is a recent treatment for vertebral compression fractures (VCF), through the swelling of an inflatable bone tamp (IBT) into the collapsed vertebral body, elevates the endplates, thereby restoring the vertebral body height and creating a void to be filled with cement. Kyphoplasty can be performed in the thoracic portion from T5 to T12 and in all lumbar levels. Although the mechanism of polymethylmethacrylate (PMMA) analgesic effect remains unknown, the key element may be the stabilization of microfractural fragments. In addition to this thermal and chemical mechanisms have been proposed.

Indications. Kyphoplasty is a technique increasingly utilized in the field of VCF based on primary and secondary osteoporosis. Further, it is extremely useful in the treatment of aggressive vertebral hemangiomas and in the bone osteolytic metastases that complicate 30% of the underlying primitive neoplasies. Additionally, kyphoplasty is indicated in the treatment of destructive multiple myeloma that is associated with VCF in 55-70% of the cases.

Contraindications. The contraindications of kyphoplasty are divided into absolute and relative. The former consist of fractures with retropulsion of the fragments within neural foramen, local infection (osteomyelitis, discitis or epidural abscess), coagulative disorders, pain not related to vertebral collapse, steady asymptomatic fractures, effective medical therapy and pregnancy. The latter are due to the inability of the patient to stay in the prone position during the procedure, the severe compression of the vertebral body, the missing integrity of pedicles or joint facets, the spread of tumor within the epidural space and, finally, an allergy connected to the medium contrast agents.

We can supply both instruments and training eductation for Kyphoplasty.