Surgery for Kyphosis

The specific treatment for kyphosis will depend upon where in the spine it exists, its cause, and the severity of the condition and its complications, as well as the health and age of an individual. Surgery can improve quality of life, and a medical team will often recommend surgery for high degrees of kyphosis that cause severe pain, digestion and/or breathing difficulties, create heart problems, neurological issues, or are progressive. Most kyphosis surgeries are done for those reasons, although sometimes the kyphosis causes a physical deformity that an individual finds unbearable.

The loss of proper spacing and cushioning between vertebrae can lead to debilitating pain that can be resolved through minimally invasive surgery, as can spinal compression fractures that lead to kyphosis. The goal of the surgery is to fuse and repair any fractures, eliminate pain, and restore posture and ease of movement. The most common surgical procedures for spinal compression fractures are spinal fusion and vertebroplasty or kyphoplasty.

Recent advances in spinal fusion surgery include the use of microscopes and tubes to minimize tissue trauma, as well as the introduction of computerized image guidance, also called surgical navigation. The neurosurgical team at Och Spine at NewYork-Presbyterian at the Weill Cornell Medicine Center for Comprehensive Spine Care are world leaders in minimal-access spine surgery to stop the progression of the kyphosis, repair fractures, correct deformities, straighten the spine as much as possible, and reduce spinal pressure, pain, and nerve damage.

Minimally invasive spinal fusions do not require a large incision or the muscle retraction typically used in conventional fusions. Patients undergoing this procedure have a fast recovery time.

• Spinal fusion is surgery to fuse together two vertebrae to eliminate motion between them and to relieve pain. For the cervical area, this procedure connects two or more vertebrae together within the neck region with metal screws and rods so they have a chance to grow together, or fuse. Spinal fusion surgery restores the space between the vertebrae and fuses the bones in place using instrumentation (rods and screws) to hold them in position and bone grafts (a slurry of bone material that hardens over time) to permanently prevent the vertebrae from moving.
• Osteotomy: During this surgical procedure, bone is cut to correct angular deformities. The bone ends are realigned and allowed to heal.
• Progressive kyphosis may successfully be treated with vertebroplasty or kyphoplasty, image-guided procedures performed in an operating room with X-ray equipment. The main goal is to return the damaged vertebrae as close as possible to their original height, prevent progression of the kyphosis, stabilize the bone, and relieve pain. Both vertebroplasty and kyphoplasty are successful about 80% to 90% of the time in relieving the pain of fractured vertebrae. Both procedures involve the injection of a polymer (“bone cement”) into the fractured bone.
  • In a vertebroplasty, the surgeon advances a needle through a small opening in the skin on a patient’s back under X-ray guidance into the fractured vertebra. After the X-ray confirms good needle placement, the surgeon injects bone cement into it. The cement hardens in a few minutes, providing immediate stability to the bone and relief of pain.
  • Kyphoplasty, also referred to as “balloon vertebroplasty,” differs slightly from vertebroplasty, as it involves the extra step of balloon inflation in the fractured bone to correct the abnormal wedging. The balloons are then removed, and the cement is infused as in a vertebroplasty.

Both procedures are performed with the patient in a prone position (face down). The team at Weill Cornell Medicine Neurosurgery typically performs these procedures with local anesthesia and sedation (“twilight” anesthesia, similar to what a person receives during a colonoscopy). Only rarely is general anesthesia required. (Download our brochure about vertebroplasty and kyphoplasty.)

The spine surgeons at Weill Cornell Medicine Neurological Surgery are fortunate to be part of Och Spine at NewYork-Presbyterian/Weill Cornell Medical Center (see Doctors Who Treat Kyphosis), which has been named one of the top hospitals in the United States by US News and World Report for 20 consecutive years.