Kyphoplasty vs Vertebroplasty: Choosing the Right Procedure for a Spine Fracture
Both kyphoplasty and vertebroplasty stabilize a fractured vertebra by injecting bone cement into the broken bone. The procedures sound similar, and they treat the same condition — vertebral compression fractures — but they have important technical and clinical differences.
I’m Dr. Keith Schmidt, a triple board-certified pain medicine physician in Hoffman Estates, Illinois. Here’s how to think about choosing between these two procedures.
What kyphoplasty does
In kyphoplasty, a small balloon is inserted into the fractured vertebra and inflated. The balloon creates a cavity inside the bone and partially restores some of the lost vertebral height. Bone cement is then injected into the cavity at low pressure, where it fills the space and hardens to stabilize the fracture.
What vertebroplasty does
In vertebroplasty, bone cement is injected directly into the fractured vertebra without first using a balloon. The cement infiltrates the existing fracture lines and stabilizes the bone, but no attempt is made to restore vertebral height.
The key technical differences
Two technical differences drive the clinical comparison:
Height restoration. Kyphoplasty’s balloon expansion can partially restore vertebral height in fractures less than a few weeks old. Vertebroplasty cannot.
Cement delivery pressure. Because kyphoplasty creates a low-pressure cavity first, cement can be injected at lower pressure than in vertebroplasty. Lower pressure may reduce the risk of cement leaking out of the vertebra into surrounding structures.
When kyphoplasty is the better choice
Kyphoplasty is generally preferred for:
Acute fractures where some height restoration may be possible.
Fractures in the thoracolumbar region where leakage risk is more concerning.
Patients who want the option of partial vertebral height restoration.
When vertebroplasty might be considered
Vertebroplasty may be considered for:
Older fractures where height restoration is not realistic.
Specific anatomic situations where balloon access is technically difficult.
Cost-sensitive situations in some healthcare systems, though cost differences are smaller in the U.S.
What both procedures share
Both procedures provide rapid pain relief in most patients — often within 24 to 48 hours. Both are minimally invasive, performed through small incisions under local anesthesia and sedation. Both have excellent safety profiles when performed under image guidance by experienced physicians.
Recovery for both is similar: most patients are walking within hours, returning to normal activities within a week, and avoiding heavy lifting for 4 to 6 weeks.
Frequently Asked Questions
Which procedure relieves pain better?
Both procedures provide excellent pain relief in most patients with acute vertebral compression fractures. Outcomes are clinically similar in most studies. The choice between them is driven more by technical factors than by pain relief differences.
Is kyphoplasty more expensive?
Kyphoplasty typically costs more than vertebroplasty due to the additional balloon equipment. In the U.S., both are covered by major insurance plans including Medicare for documented compression fractures, and the patient cost difference is usually modest.
Can I have either procedure if my fracture is old?
The window for effective treatment is typically within 3 to 6 months of the fracture, though some patients respond outside that window. Older fractures are less likely to respond to either procedure because the bone has often fully healed in its collapsed position.
What are the risks?
Both procedures carry small risks of cement leakage, infection, bleeding, and very rarely, neurological injury. Image guidance throughout the procedure minimizes these risks. Most patients have no significant complications.
How long do the results last?
The treated vertebra is permanently stabilized — the cement does not break down. However, patients with osteoporosis remain at risk for new fractures at other levels. Comprehensive osteoporosis management is essential to prevent additional fractures.
Will insurance cover the procedure I need?
Yes. Major insurance plans including Medicare cover both kyphoplasty and vertebroplasty for documented vertebral compression fractures when conservative care has been tried. Our office handles prior authorization.
Schedule a consultation
If you have a recent vertebral compression fracture and want to discuss whether kyphoplasty or vertebroplasty fits your situation, schedule a consultation or call our office at (847) 981-3630.