Houston Methodist. Leading Medicine

Upper Spine FAQ

Question:

I have two lumber vertebrae that were fractured and treated with kyphoplasty. I was warned about the possibility of cement oozing out and causing complications. Fortunately, this did not happen. But if it had, what would it have felt like?

Answer:

Patients with osteoporosis (decreased bone density or brittle bones) are prone to compression fractures in the spine bones, or vertebrae. The bone cracks under pressure, causing it to collapse in height. The fracture angles the spine forward and produces a hunchbacked appearance, called kyphosis. Patients with this condition are subject to debilitating pain, disturbed sleep, decreased lung and intestinal function, and difficulty completing routine activities. Kyphoplasty restores the size and strength of the fractured vertebra. This realigns the spine and reduces pain. Nearly 95 percent of patients get immediate relief of pain with this procedure. But there are some potential complications or problems that can occur. One is, as you mentioned, the oozing of cement into the surrounding soft tissues. But the cement oozes out and damages nearby blood vessels and nerves. The oozing cement can also form an emboli (clot) that can travel to the heart or brain and make matters much worse. One other problem is that injecting cement into the main body of the vertebral bone creates a rigid bone that is actually too stiff for the weak (osteoporotic) bone. The result can be even more fractures in the vertebrae above and below the cemented level. But vertebral compression fractures (VCFs) caused by weak, osteoporotic bones can't be just left to heal on their own. The end result would be further collapse of spine, chest, and abdomen affecting breathing, appetite, and digestion. And since most of the VCFs occur in adults aged 65 or older, there can be additional complications associated with these problems. Older patients aren't the only ones affected. Younger patients can experience any of these problems, too. In addition, the implant is expected to be permanent. It doesn't break down and it isn't absorbed by the body. This feature could cause problems later for the younger patients. You aren't likely to actually feel the movement of cement into the soft tissues. You are more likely to experience symptoms from the effects of the cement coming in contact with blood vessels and nerves. The heat from the chemical process involved may be what injures these tissues. Irritation of the nerves can cause pain, numbness, or other sensory symptoms. Emboli can result in a heart attack or stroke. Patients are usually told what to look for as potential symptoms of the more serious complications of kyphoplasty from cement extravasation (oozing). Fortunately, you did not experience any of these! Hossein Ghofrani, MD, et al. An Evaluation of Fracture Stabilization Comparing Kyphoplasty and Titanium Mesh Repair Techniques for Vertebral Compression Fractures. Is Bone Cement Really Necessary? In Spine. July 15, 2010. Vol. 35. No. 16. Pp. E768-E773.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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