Kyphoplasty is a minimally invasive spine procedure that repairs vertebral compression fractures, the small collapses in spinal bones most commonly caused by osteoporosis. A surgeon inflates a tiny balloon inside the damaged vertebra to restore its height, then fills the space with bone cement to stabilize the fracture. The procedure typically takes under an hour and most people go home the same day.
How the Procedure Works
Kyphoplasty is performed while you lie face down, usually under general anesthesia or sedation. The surgeon makes a small incision and guides a hollow needle through the back of the vertebra using real-time X-ray imaging (fluoroscopy). The needle is advanced into the front-to-middle portion of the fractured bone, as close to the center as possible.
Once the needle is positioned, a deflated balloon is threaded through it and into the vertebral body. The surgeon inflates the balloon with a contrast fluid visible on X-ray, carefully watching as it expands. Inflation continues until one of three things happens: the vertebral height is restored, the balloon reaches the edges of the bone, or it hits the manufacturer’s pressure limit. This step is what distinguishes kyphoplasty from its older cousin, vertebroplasty, which skips the balloon entirely and injects cement directly into the fractured bone.
After the balloon is deflated and removed, it leaves behind a cavity. The surgeon then injects bone cement, a paste-like material, into that space in small doses of about half a cubic centimeter at a time. Each injection is monitored on fluoroscopy to make sure cement stays within the bone and doesn’t leak out. The cement hardens in place within minutes, and the needle is withdrawn. In some cases the surgeon repeats the process on the other side of the same vertebra for better fracture support and more complete cement filling.
Who Is a Candidate
Kyphoplasty is designed for people with recent vertebral compression fractures, typically those that occurred within the past three months. The most common cause is osteoporosis, but fractures from cancers like myeloma or from spinal tumors (metastases) can also be treated this way. The key requirement is that the fracture is causing significant pain that hasn’t responded to conservative treatments like rest, bracing, or pain medication.
Not everyone qualifies. If the vertebra has completely collapsed into a flat shape (called vertebra plana), there isn’t enough structure left for the balloon to work with. Unstable fractures that could shift and compress the spinal cord are also ruled out, as are patients with blood clotting disorders that make the procedure unsafe. Fractures causing neurological symptoms like leg weakness or numbness typically need a different surgical approach.
Pain Relief and Outcomes
Most people experience meaningful pain relief after kyphoplasty. In one large systematic review, 92% of patients who underwent the procedure reported significant improvement. A long-term follow-up study found that average pain scores dropped by 47%, from a pre-procedure rating of 8 out of 10 down to 3 out of 10. About 85% of kyphoplasty patients in that study experienced measurable pain reduction, and roughly 80% of all patients reported improved mobility afterward.
These results tend to be somewhat better than those seen with vertebroplasty, where about 64% of patients reported pain relief in the same study. That difference likely comes down to the balloon step: restoring some of the lost vertebral height can improve spinal alignment and reduce the forward-hunched posture (kyphosis) that makes compression fractures so painful. However, biomechanical research suggests that height restoration can diminish over time with repeated loading on the spine, so the postural gains aren’t always permanent.
How Kyphoplasty Differs From Vertebroplasty
Both procedures inject bone cement into a fractured vertebra, but kyphoplasty adds the balloon inflation step. This matters for two reasons. First, the balloon creates a defined cavity, so the cement fills a contained space rather than seeping through fractured bone. Second, inflating the balloon can partially restore the vertebra’s original shape before the cement locks it in place. Vertebroplasty doesn’t attempt height restoration.
The practical difference shows up most clearly in complication rates. Cement leakage, where the material escapes beyond the vertebral body, occurs in about 9% of kyphoplasty cases compared to roughly 40% with vertebroplasty. Neurological complications are also far less common: 0.03% for kyphoplasty versus 0.6% for vertebroplasty. The balloon creates a lower-pressure environment for the cement, which is the main reason it stays where it belongs more reliably.
Risks and Complications
Kyphoplasty is considered safe, but no procedure is without risk. Cement leakage is the most common concern, occurring in about 29% of treated vertebrae in one systematic review, though the vast majority of these leaks are small and cause no symptoms. In rare cases, leaked cement can press on spinal nerves or travel into surrounding blood vessels.
Other potential complications include infection at the needle site, bleeding, and allergic reactions to anesthesia. There is also a small risk of fractures developing in adjacent vertebrae after the procedure, partly because the cemented bone becomes stiffer than its neighbors and may transfer more force to them during movement. This risk exists with or without the procedure in people with osteoporosis, so it’s difficult to attribute entirely to the cement.
Recovery and Activity Restrictions
Kyphoplasty is typically an outpatient procedure. You’ll spend at least two hours in recovery before going home. Walking is encouraged right away, but your spine needs protection while the surrounding tissues heal.
For four to six weeks after the procedure, you should avoid bending at the waist, twisting your torso, or lifting anything heavier than five pounds. That means everyday tasks like tying your shoes or picking up a bag of groceries will need a workaround. Showering is fine, but baths, swimming, and hot tubs are off limits for seven to ten days while the incision site heals. Treadmills should also be avoided during the recovery period, though regular walking on flat ground is safe and encouraged.
Most people notice pain improvement within the first few days, though some soreness at the needle insertion site is normal. The bone cement hardens during the procedure itself, so the structural repair is immediate. The recovery restrictions are primarily about protecting your spine from the forces of bending and lifting while surrounding soft tissue heals.