30/01/2026
Balloon Kyphoplasty Technique (स्टेप-बाय-स्टेप)
Balloon kyphoplasty एक minimally invasive spine procedure है, जो ज़्यादातर vertebral compression fracture (VCF) में किया जाता है—जैसे osteoporosis, trauma, या pathological fractures (myeloma, metastasis)।
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🎯 Indications
Osteoporotic vertebral compression fracture (acute / subacute)
Painful vertebral collapse not responding to conservative therapy
Vertebral height loss के साथ kyphotic deformity
Selected pathological fractures (no posterior wall breach)
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🚫 Contraindications
Active infection (local/systemic)
Asymptomatic fractures
Severe posterior wall defect with canal compromise
Uncorrected coagulopathy
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🔧 Balloon Kyphoplasty – Technique Steps
1️⃣ Patient Positioning
Prone position
Chest & pelvic bolsters → abdomen free (venous pressure ↓)
Procedure under fluoroscopy (C-arm)
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2️⃣ Anaesthesia
Local + conscious sedation
Or general anaesthesia (elderly / multiple level)
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3️⃣ Pedicle Access
Transpedicular approach (thoracic/lumbar)
Jamshidi needle inserted under AP & lateral fluoroscopy
Cannula placed into vertebral body
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4️⃣ Balloon Insertion
Working cannula के through inflatable bone tamp (balloon) inserted
Balloon placed in anterior one-third of vertebral body
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5️⃣ Balloon Inflation
Gradual inflation with contrast medium
Purposes:
Vertebral height restoration
Kyphotic angle correction
Create cavity for cement
Inflation stopped when:
Desired height achieved
Cortical contact
Pressure limit reached
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6️⃣ Balloon Deflation & Removal
Balloon deflated and removed
A void/cavity remains inside vertebral body
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7️⃣ Cement Injection
High-viscosity PMMA bone cement
Injected slowly under continuous fluoroscopy
Lower pressure than vertebroplasty → cement leak risk ↓
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8️⃣ Closure
Cannula removal
Small skin closure (usually single suture or dressing)
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⏱ Procedure Time
~30–45 minutes per level
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✅ Advantages of Balloon Kyphoplasty
Immediate pain relief (often within 24 hrs)
Vertebral height restoration
Kyphosis correction
Cement leakage risk less than vertebroplasty
Early mobilization
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⚠️ Possible Complications
Cement leakage (rare but possible)
Infection
Adjacent level fracture
Pulmonary cement embolism (very rare)
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🆚 Kyphoplasty vs Vertebroplasty (Quick Compare)
Feature Kyphoplasty Vertebroplasty
Balloon used ✔ Yes ❌ No
Height restoration ✔ Better ❌ Minimal
Cement pressure Low High
Cement leakage Less More
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📝 Clinical Tip (Pain Physician / Spine Interventionist)
Acute fractures (
