When osteoporosis or an injury causes the bones in your spine to collapse, these procedures act as an internal cast. By injecting a special medical-grade cement into the broken bone, doctors can quickly stabilize the fracture and relieve severe back pain.
Common Indications for Vertebroplasty/Kyphoplasty
Your doctor may recommend these procedures if you have:
- A painful spinal compression fracture caused by osteoporosis.
- A fractured vertebra due to a spinal tumor or cancer.
- Severe back pain from a fracture that has not improved with bed rest or pain medication.
What is the difference between the two?
Both procedures aim to fix the broken bone using cement, but they do it slightly differently:
- Vertebroplasty: The doctor injects the medical cement directly into the collapsed bone to lock it in place.
- Kyphoplasty: Before injecting the cement, the doctor inserts a tiny balloon into the bone and inflates it. This creates a small space and helps restore some of the bone's original height before the cement is added to keep it strong.
What happens during the procedure?
You will lie flat on your stomach on an imaging table. The doctor will use continuous X-ray pictures to safely guide a hollow needle through your back and into the fractured vertebra. You will receive numbing medicine and relaxing IV sedation so you stay comfortable. The cement is then carefully injected, and it hardens in about 10 to 15 minutes.
Will it be painful?
You may feel stinging from local anesthetic and deep pressure as the needle is positioned. You will not feel cement polymerization itself. Pain relief is variable: some patients improve quickly, some gradually, and some not at all. Benefit is most plausible when the painful recent fracture is carefully confirmed and other causes of pain are excluded.
Do I need to prepare?
Fasting depends on the sedation plan. Give the team a complete anticoagulant and antiplatelet history, but do not stop treatment yourself; the procedural and prescribing clinicians must provide an individualized plan.
What should I confirm before booking this procedure?
These are specialist spine procedures, so confirm that the centre has fluoroscopy or CT guidance, a clinician experienced in vertebral augmentation, and a recovery area where you can be observed after sedation. Ask whether you need a recent MRI or CT to prove the fracture is fresh and painful, because not every old compression fracture benefits from cement injection.
Also ask about the full cost, including consultation, procedure, sedation, cement kit, recovery stay, and follow-up. If the fracture may be related to cancer, infection, or severe osteoporosis, your referring doctor may need to coordinate treatment beyond the procedure itself.
What are the important limitations and safety checks?
Interventional radiology is minimally invasive, but it is not risk-free and is not automatically safer or more effective than surgery, endoscopy, medicines, or observation for every patient. Technical success does not always produce symptom relief or cure disease, and repeat treatment or another approach may be needed. Suitability depends on anatomy, disease severity, comorbidities, imaging, local expertise, and the alternatives available.
Risks vary by procedure and may include pain, bleeding, infection, contrast reaction, kidney injury, radiation exposure, vessel or organ injury, clotting, device movement or blockage, sedation complications, treatment failure, and an unplanned operation or admission. Tissue sampling can be nondiagnostic and requires pathology; tumor treatments require oncology follow-up. The consent discussion should cover the patient-specific benefits, material risks, alternatives, and what happens if the procedure cannot be completed.
Preparation is individualized. Give the team a complete list of anticoagulants, antiplatelet drugs, diabetes medicines, supplements, allergies, kidney problems, pregnancy possibility, and prior contrast reactions. Do not stop a blood thinner or diabetes medicine on your own: the procedural team and prescribing clinician must balance bleeding against thrombosis or metabolic risk and provide exact written instructions. Fasting, laboratory tests, antibiotics, sedation, escort, admission, and aftercare differ by procedure.
Know the urgent warning signs
After an IR procedure, seek urgent help for uncontrolled bleeding, fainting, chest pain, severe breathlessness, new weakness or confusion, a cold or very painful limb, fever or rigors, rapidly worsening pain or swelling, or a drain or tube that stops working, leaks, breaks, or comes out. Use the procedure-specific discharge instructions and emergency contact number.
Sources and further reading
- CIRSE: Interventional-radiology procedures
- CIRSE: Clinical Practice Manual
- American College of Radiology: Manual on Contrast Media
Conclusion
Vertebral augmentation may help selected patients with a confirmed painful recent compression fracture after appropriate conservative care, but evidence and benefit vary by indication. Cement leakage, nerve or spinal-cord injury, pulmonary embolism, infection, bleeding, adjacent fracture, and no pain improvement are important risks; osteoporosis or cancer care must continue.