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  • Tolgay Şatana

What is the Difference of Kyphoplasty-Vertebroplasty?


Kyphosis; It is a definition that means hunchback, which includes the conditions that cause the spine to bend forward in the medical language. It is a structural deformity, it may be congenital or as an acquired disease, causing collapse in the vertebrae and may result in kyphosis.

Humpback treatment is eliminated by the corrective interventions of spine surgery. Since it is generally an intervention performed at a young age, open surgery covers major surgeries using metal screw and rod systems. Since it is one of the most severe surgeries in orthopedics, surgical treatment of humpback and problems caused by aging was avoided.

The method of bone cement injection to fill the gap created by a bone tumor in the spine, first applied by a Radiologist Drummond in 1984, when “osteoporosis = decrease in bone density” emerged as a cause of reducing the quality of life of the elderly population in societies with the increase in the elderly population after the Second World War; The definition of “vertebroplasty” has begun to be used.

Osteoporosis patients were disconnected from daily life due to both deformity and pain, and they were lost due to fatal causes, from embolism to respiratory problems due to immobility.

Vertebroplasty method not only fills the gap in vertebral tumors that destroy and weaken the bone structure, but also ensures the destruction of the bone tumor with the cement used. The situation is a little different in osteoporosis. Cement is injected using high pressure with vertebraplasty since there is no cavity to be injected although the bone density decreases. Its use has been restricted because the cement injected with high pressure leaks into the spinal canal and reaches the lungs through the blood. During these periods, the idea that balloons used in vascular surgery would straighten the spine of osteoporotic patients in the bone, create a gap and replace it with cement was developed and put into practice. After the first applications were carried out successfully in Chicago, the concept of “Kyphoplasty” became one of the treatment options.

The final point reached in the vertebroplasty-kyphoplasty debate, in which physicians performing spine surgery in the last fifteen years question their habits, is that kyphoplasty is safer and its effect on kyphosis correction is significant. However, kyphoplasty is ineffective in the treatment of structural humpback. It is effective in vertebral collapse due to fresh osteoporotic fractures and tumors. Although there is still no consensus among surgeons on cement leakage, both methods can be safely applied, respecting the physician’s habit. My personal practice is that kyphoplasty is safer.

Finally, we prefer the use of cement as a filling material only in tumor patients. We use organic products such as calcium-phosphate that regenerate bone instead of fillers that cannot be absorbed and destroyed in polymethyl methacrylate content. Although these products are not mechanically very robust, they are not different in terms of efficiency. In addition, it keeps us away from the disasters that polymethyls cause by destroying bones in the long term.

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