Frequently Asked Questions

What is a spinal fracture?
Are spinal fractures difficult to diagnose?
Why should I be concerned about spinal fractures?
What are the symptoms of a spinal fracture?
Can spinal fractures affect my overall health?
What are the psychosocial effects of spinal fractures?
What is osteoporosis?
Who is at risk for an osteoporosis-related fracture?
Is osteoporosis preventable?
What are the risk factors for osteoporosis?
How common is osteoporosis?

Back Pain and Spinal Fractures

How does "normal" back pain compare with pain from a spinal fracture?
What can happen if a spinal fracture isn’t diagnosed and treated?

Balloon Kyphoplasty

How have spinal fractures been treated in the past?
How long does balloon kyphoplasty take? What type of anesthesia is used?
What are the potential benefits of balloon kyphoplasty?
Are there risks associated with balloon kyphoplasty?
What can a patient reasonably expect after having balloon kyphoplasty?
Can a spinal fracture that occurred a long time ago be treated with balloon kyphoplasty?
Can any doctor perform balloon kyphoplasty?
What type of doctor can be trained to perform balloon kyphoplasty?
How many doctors have been trained to perform balloon kyphoplasty?
How many patients have been treated with balloon kyphoplasty?
Where can I find more information about balloon kyphoplasty?

Q: What is a spinal fracture?
A: Fractures of the bones that make up the spinal column are called spinal fractures or vertebral compression fractures. Mistakenly considered a ''normal'' part of aging, the stooped posture that occurs with multiple fractures contributes to chronic pain, reduced quality of life and an increased risk for more fractures. [11,21,22,51,52,64,67,70]
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Q: Are spinal fractures difficult to diagnose?
A: Not really, although they do tend to be under-recognized by physicians and patients alike. About two-thirds of all osteoporosis-related spinal fractures are not diagnosed [5,72], primarily because: [1]

• Patients with spinal fractures may have mild, or very little discomfort [1]
• Patients may consider back pain a normal part of aging [1]
• Patients and physicians may not realize the importance of obtaining a proper diagnosis [1]

A complete physical exam, together with an X-ray and/or Magnetic Resonance Imaging (MRI), can help your physician differentiate between pain caused by a spinal fracture or pain caused by other disorders.
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Q: Why should I be concerned about spinal fractures?
A: After just one spinal fracture, your risk for having another fracture is 3-5 times greater than before because the broken bone [39,70]  affects the distribution of weight along the spinal column. Misalignment brought on by a fractured vertebral body places more stress on adjacent vertebrae; the front of the spine is forced to withstand more stress or weight with fewer functioning parts, resulting in a structure that is now weakened and more vulnerable to additional fracture.
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Q: What are the symptoms of a spinal fracture?
A: Most spinal fractures have a gradual onset unrelated to specific injury. Fractures can occur as a result of normal activity; i.e., bending over or reaching for something. In some cases, patients experience sudden and severe back pain without engaging in activity at all. The fact that a spinal fracture can be easily confused with other back problems underscores the importance of obtaining a correct diagnosis and receiving treatment. Complicating the issue of spinal fracture diagnosis is the fact that patients can have pain from a fracture and the fracture may not show up on X-ray for several weeks. If your doctor does not find a fracture on the initial X-ray, but you have persistent back pain with no clear cause, consider asking for a second X-ray. Sometimes an MRI may be appropriate.
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Q: Can spinal fractures affect my overall health?
A: Multiple spinal fractures can cause a forward curvature of the spine (kyphosis). This increases your risk for future fracture and can reduce your quality of life. With each additional fracture, the spinal curvature can become more pronounced, painful and debilitating. Severe kyphosis has a "compression effect" on your organs, making it progressively difficult to breathe, walk, eat or sleep. Lung capacity is reduced and mobility can become limited. Early satiety (a feeling of fullness after having eaten only a small amount) can cause you to lose weight and become malnourished. Finally, sleep disorders are common with pronounced kyphosis. [10,21,22,51,52,62,63,64,65,66,67]
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Q: What are the psychosocial effects of spinal fractures?
A: In addition to medical complications, patients with spinal fractures can experience depression, anxiety and lowered self-esteem. The alterations in lifestyle that accompany severe kyphosis can profoundly affect well-being and cause feelings of isolation and sadness. [21,52,64,73]
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Q: What is osteoporosis?
A: Osteoporosis is a disease in which bones become fragile and weak, causing them to break more easily than normal bone. Often referred to as the “silent thief”, osteoporosis usually progresses without obvious signs or symptoms until the first fracture occurs. According to a large-scale epidemiologic follow-up study, approximately 1.4 million vertebral fractures due to osteoporosis occur annually in Europe. [3]
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Q: Who is at risk for an osteoporosis-related fracture?
A: The International Osteoporosis Foundation estimates that 40% of women and 15% of men over the age of 50 will have one or more osteoporosis-related fractures in their lifetime; however, changes that weaken bone in women can begin as early as age 30. Additionally, long-term use of medications such as corticosteroids can weaken bone. [74]
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Q: Is osteoporosis preventable?
A: Osteoporosis prevention should begin in childhood with a calcium-rich diet, regular weight-bearing exercise and either safe exposure to sunshine or vitamin D supplementation is recommended. In adulthood, continuing to eat foods rich in calcium, getting sunshine or taking vitamin D, regular exercise and avoidance of smoking and excessive alcohol can help your body maintain healthy bone.
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Q: What are the risk factors for osteoporosis ?
A: The International Osteoporosis Foundation has identified the following as risk factors for osteoporosis: [74]

• Family history of osteoporosis or fractures (in a close relative)
• Broken bone after age 50
• Height loss of more than 3 cm (just over 1 inch) in adulthood
• Low calcium in diet
• Smoking, excessive alcohol consumption or taking certain medications (e.g. glucocorticoids)
• Normal or early menopause (before age 45)
• Low testosterone in men

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Q: How common is osteoporosis?
A: One in three women and one in five men over age 50 will have an osteoporosis-related fracture in her/his remaining lifetime. The International Osteoporosis Foundation cites osteoporosis as a major public threat affecting 19 million Europeans (45% of the population aged 50 and older). [1,74]
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Back Pain and Spinal Fractures

Q: How does “normal” back pain compare with the pain of a spinal fracture?
A: There are many potential sources of non-fracture related back pain. Sudden, severe back pain, unrelated to specific injury, may indicate that a spinal fracture has occurred. Regardless of the intensity of back pain, it’s never wise to self-diagnose. Patients experiencing back pain should go to their doctor for a physical exam.
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Q: What can happen if a spinal fracture isn’t diagnosed and treated?
A: Left untreated, one fracture can lead to another, resulting in kyphosis (curvature of the spine) and an overall decline in health. Kyphotic deformity and progressive bone weakness increase your risk for additional fractures and can adversely affect your ability to breathe, walk, eat or sleep. Consult with your physician to determine your condition and the appropriate treatment. [10,11,21,22,51,52,62-70]
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Balloon Kyphoplasty

Q: How have spinal fractures been treated in the past?
A: Traditional treatment for spinal fractures includes extended bedrest, pain medication and back braces. These treatments can reduce pain, but do not stabilize the fracture or correct the related spinal deformity.
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Q: How long does balloon kyphoplasty take? What type of anesthesia is used?
A: On average, the procedure takes about one hour per fracture treated and may be done on an inpatient or outpatient basis, depending on medical necessity. Balloon kyphoplasty can be done under local or general anesthesia; the physician will recommend the most appropriate sedation based on the patient’s general condition. After the procedure, the doctor will most likely schedule a follow-up visit and explain limitations, if any, on physical activity.
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Q: What can a patient reasonably expect after undergoing balloon kyphoplasty?
A: Published studies report a marked reduction in pain, sometimes within hours of the procedure. Balloon kyphoplasty has been shown to improve mobility and enable patients to return to everyday activities such as walking, bending, and lifting, with significantly less pain than they had prior to the procedure. Patients report improved mental health, vitality, social function and emotional well-being. [17,19]
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Q: Can a spinal fracture that occurred a long time ago be treated with balloon kyphoplasty?
A: Age of a spinal fracture and treatment success varies from patient to patient; however, physicians generally agree that the earlier a fracture is treated, the better the chances for deformity correction. [75]
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Q: Can any doctor perform balloon kyphoplasty?
A: Doctors performing balloon kyphoplasty first attend a special training course taught by physicians who have extensive experience with the procedure. For the benefit of patients, Kyphon maintains a list of doctors who are trained to perform balloon kyphoplasty and who have indicated a willingness to accept patient referrals.
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Q: What type of doctor can be trained to perform balloon kyphoplasty?
A: Orthopaedic surgeons, neurosurgeons, interventional neuroradiologists, and pain management specialists who specialize in treating the spine can perform balloon kyphoplasty. Physicians who treat patients with osteoporosis (general practitioners, rheumatologists, endocrinologists, physiotherapists, physical medicine practitioners, gynecologists and geriatricians) or cancer can refer spinal fracture patients to a surgeon or interventional radiologist trained to do the procedure. After balloon kyphoplasty, the patient should return to the referring physician for medical management.
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Q: How many doctors have been trained to perform balloon kyphoplasty?
A: To date, more than 12,800 spine specialists worldwide have been trained to perform balloon kyphoplasty.
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Q: How many patients have been treated with balloon kyphoplasty?
A: As of the end of the third quarter 2008, we have treated over 393,000 patients and 460,000 fractures worldwide with balloon kyphoplasty since we commercialized our products in 2000.
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Q: Where can I find more information about the procedure?
A: To find out more, click on the Contact Kyphon button in the navigation bar to the left.
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