Kyphoplasty vs Vertebroplasty: How the Two Differ

Kyphoplasty uses a balloon catheter to create space and restore lost vertebral height before the cement injection. In contrast, vertebroplasty places medical-grade bone cement directly into the fractured vertebral body without the balloon step. Both are minimally invasive procedures that treat painful vertebral compression fractures and support spinal stabilization.

At Total Orthopedics & Sports Medicine, our spine specialists evaluate your fracture, symptoms, and imaging results to determine which procedure suits your condition. We develop a personalized treatment plan to reduce discomfort, improve spinal stabilization, and support improved mobility. After treatment, our specialists schedule follow-up appointments to assess your recovery and vertebral health. Call 855-321-6784 to schedule a consultation.

What Is the Difference Between Kyphoplasty and Vertebroplasty?

Kyphoplasty creates a small cavity with an inflatable balloon catheter before the surgeon adds bone cement to support the fractured vertebra. In contrast, vertebroplasty places medical-grade bone cement directly into the damaged vertebral body without a balloon. Both minimally invasive procedures stabilize vertebral compression fractures and can provide pain relief.

In fact, a study published in Current Reviews in Musculoskeletal Medicine found that both procedures reduced pain after vertebral body fractures. Across 69 clinical studies, 92% of patients who had kyphoplasty reported pain relief. Vertebroplasty achieved pain relief in 87% of patients. Both procedures also showed significant improvement in physical function. Beyond these clinical improvements, biomechanical studies have found greater initial restoration of vertebral height with kyphoplasty.

While both procedures use bone cement for spinal stabilization, their technique and treatment goals differ. Here are the key differences between kyphoplasty and vertebroplasty:

What Happens During Vertebroplasty?

Vertebroplasty stabilizes a fractured spinal bone through a targeted cement injection that usually takes about one hour. During the procedure, you receive local anesthesia to numb the area, often with sedation to keep you comfortable. Then, your doctor uses fluoroscopy (real-time X-ray guidance) to locate the fractured vertebral body and guide accurate needle insertion.

Once the fractured area is located, the doctor inserts a hollow needle through a small skin incision and guides it into the broken vertebra. Through this needle, the doctor slowly delivers medical-grade bone cement into the fractured bone. This percutaneous injection (through a small opening in the skin) fills the spaces within the fracture and provides spinal stabilization.

After the cement enters the fracture, it hardens within minutes and acts like an internal cast to stabilize the damaged bone. Then, your doctor removes the needle and covers the puncture site with a small bandage. Once this monitoring is complete, you can usually return home the same day.

Why Does Kyphoplasty Use a Balloon Before Bone Cement?

Kyphoplasty uses a small balloon catheter to lift the collapsed vertebra and create a cavity before cement placement. As the balloon expands, it gently raises the compressed bone and can restore lost vertebral height. This correction can also reduce abnormal spinal curvature after a vertebral compression fracture.

Once the cavity forms, your surgeon removes the balloon and fills the open space with medical-grade bone cement. The prepared cavity allows thicker cement to enter at lower pressure. This controlled placement reduces the risk of cement leaking into nearby tissues or blood vessels. At the same time, the defined space allows the cement to support and stabilize the fractured vertebral body.

Can Kyphoplasty Restore More Vertebral Height?

Yes, kyphoplasty can partially or fully restore lost vertebral height after a spinal compression fracture. During the procedure, your surgeon inflates a balloon catheter inside the collapsed vertebral body to lift the compressed bone toward its original position. This step creates a cavity that supports the corrected vertebral body height.

Then, your surgeon removes the balloon and fills the space with cement to stabilize the restored structure. In fact, a review from the National Library of Medicine found that kyphoplasty restored an average of 2.7 mm of vertebral height. In comparison, vertebroplasty restored an average of 0.7 mm.

Another study published in the Journal of Spine Surgery evaluated 59 patients who underwent kyphoplasty for painful vertebral compression fractures. Researchers found that 90.7% of treated vertebrae gained height in at least one measured area. Most patients also had less pain, better physical function, and improved quality of life after treatment. However, greater height restoration did not directly predict better clinical outcomes.

Kyphoplasty vs Vertebroplasty: Which Provides Better Pain Relief?

According to the Journal of Orthopaedic Surgery and Research, both procedures provide similar pain relief. Researchers analyzed 16 randomized controlled trials with 1,738 patients and found no significant difference in pain reduction between kyphoplasty and vertebroplasty.

However, kyphoplasty showed better outcomes for vertebral compression, Cobb angle, and cement leakage. Similarly, a study of 86 patients published in the European Spine Journal found that pain scores decreased significantly after both procedures. The improvement in pain did not differ significantly between kyphoplasty and vertebroplasty.

How Long Does Vertebroplasty Cement Last?

Vertebroplasty cement is designed to provide permanent support and usually remains inside the treated vertebra for life. The orthopedic cement hardens within about 10 to 15 minutes after injection and stabilizes the fractured bone. Once the vertebra becomes stable, pain often improves and gradually subsides.

Over time, the surrounding bone can continue to weaken even though the cement remains intact. This problem is more common in elderly patients with osteoporosis and can lead to another compression fracture. If another painful fracture develops, your pain physician may evaluate the area and recommend additional treatment.

What Are the Risks of Kyphoplasty and Vertebroplasty?

Possible risks of both procedures are cement leakage, infection, and bleeding. Cement can leak outside the treated vertebra and press on the spinal cord or nearby nerve roots. In rare cases, leaked cement can enter blood vessels and travel to the lungs, which can cause a pulmonary embolism. Infection or bleeding can also occur around the needle insertion site.

In fact, a PubMed review reported neurological complications in 0.6% of vertebroplasty cases, compared with 0.03% after kyphoplasty. Pulmonary embolism occurred in 0.6% of vertebroplasty cases and 0.01% of kyphoplasty cases. Reported adjacent-level fracture rates ranged from 8% to 52% after vertebroplasty and 3% to 29% after kyphoplasty.

These complications are uncommon when surgeons carefully select patients for treatment. Vertebroplasty and kyphoplasty are generally safe and effective procedures for appropriate spinal fractures. To ensure the procedure is suitable for you, your surgeon performs a detailed physical exam and reviews your imaging findings. This evaluation allows your surgeon to select the safer option and reduce complication risks.

Which Has More Cement Leakage: KP or Vertebroplasty?

Vertebroplasty generally has a higher cement leakage rate than kyphoplasty. A review published in Current Reviews in Musculoskeletal Medicine reported that cement extravasation (leakage) occurs in 40% of vertebroplasty cases. In comparison, the rate was only 8% after kyphoplasty. The review also found symptomatic leakage in 3% of vertebroplasty cases and none in kyphoplasty cases.

Another 2026 study published in Frontiers in Endocrinology reported cement leakage in 19.8% of vertebroplasty cases. In contrast, leakage occurred in 8.42% of kyphoplasty cases. These findings also showed a lower leakage rate with kyphoplasty.

However, reported rates vary across studies due to differences in technique, fracture type, and cement characteristics. Leakage can become more concerning if medical cement enters the spinal canal or reaches nearby structures. Your surgeon considers these factors when selecting the safest procedure for your fracture.

Can You Develop Another Fracture After Kyphoplasty?

Yes, you can develop another vertebral fracture after kyphoplasty. A study published in Spine followed 38 patients after the procedure and found that 10 patients developed 17 subsequent fractures. Of these fractures, 13 occurred at levels adjacent to the treated vertebra, while four occurred at more distant levels. Most adjacent fractures developed within the first two months after kyphoplasty.

Here are common factors that can contribute to another vertebral fracture after kyphoplasty:

• Underlying Osteoporosis: Weak bone can continue to fracture after kyphoplasty.
• Previous Fractures: A prior spinal cord compression increases the risk of future fractures.
• Steroid Use: Long-term steroid therapy can weaken bone and raise fracture risk.
• Adjacent-Level Stress: Changes in spinal mechanics may place greater stress on nearby vertebrae.

A study published in The Spine Journal also examined recurrent fractures after kyphoplasty. Researchers reviewed 109 kyphoplasty procedures in 94 patients. They reported a 10% recurrent fracture rate within the first 90 days after treatment. Patients who developed another fracture also tended to have more vertebral levels treated.

What Is Recovery Like After Kyphoplasty or Vertebroplasty?

Recovery after kyphoplasty or vertebroplasty is usually quick, and most patients go home the same day. You may have mild back soreness for 1 to 2 days, while fracture-related pain may begin to improve soon after treatment. Based on your surgeon’s instructions, you may begin gentle walking soon after the procedure.

During early recovery, your surgeon may recommend light activity while the treated vertebra heals. You should avoid heavy lifting and strenuous activity for several weeks based on your fracture and your surgeon’s instructions. Most patients gradually return to normal activities over about six weeks as their compression fracture recovery progresses.

Which Spine Procedure Takes Longer to Perform?

Kyphoplasty generally takes longer than vertebroplasty because it includes an additional balloon step. Vertebroplasty often takes about 30 to 45 minutes per spinal level. Kyphoplasty may take about 45 to 60 minutes per level, as the surgeon creates a cavity with a balloon before placing cement.

Both procedures are typically minimally invasive and performed on an outpatient or short-stay basis. The exact procedure time can vary based on the fracture, the number of spinal levels treated, and the technical complexity of the case. Treating multiple vertebrae during the same session may also require more time.

Who Is a Good Candidate for Kyphoplasty?

You may qualify for kyphoplasty if you have a recent, painful vertebral compression fracture confirmed through imaging. Your spine surgeon may also recommend this procedure when conservative treatments, such as rest and pain medication, do not provide enough relief. Persistent pain that limits walking, standing, or daily activities can further support the need for treatment.

Moreover, kyphoplasty can treat osteoporotic vertebral compression fractures caused by primary osteoporosis, trauma, or certain cancer-related conditions. Cancer patients with conditions such as multiple myeloma can also develop painful vertebral collapse. In these cases, kyphoplasty can stabilize the fractured vertebra and reduce fracture-related pain.

When Do Surgeons Recommend Vertebroplasty Over KP?

Surgeons may recommend vertebroplasty when a fractured vertebra needs stabilization without significant height restoration. They may also recommend this procedure when painful vertebral body fractures cause significant discomfort despite nonsurgical care. In these cases, imaging can confirm that the fracture is still active and requires direct vertebral stabilization.

Surgeons may also recommend vertebroplasty over kyphoplasty in these situations:

• Minimal Height Loss: The vertebra needs stabilization rather than height restoration.
• Narrow Pedicles: Smaller needles can provide easier access to the fractured vertebra.
• Limited Deformity: The fracture does not require correction of spinal shape.
• Direct Cement Placement: The fracture can be filled with cement without a balloon cavity.

Important Note: The most suitable procedure depends on your fracture pattern, spinal anatomy, symptoms, and overall health.

Which Procedure Is Better for an Older Compression Fracture?

Neither procedure is usually ideal once an older fracture has fully healed and hardened. However, kyphoplasty may still be recommended when painful vertebral fractures remain active despite treatment. In selected cases, the procedure can stabilize the vertebra and provide significant pain relief. The following factors also guide the decision to treat spinal compression fractures with vertebroplasty or kyphoplasty:

1. Fracture Timing

Kyphoplasty may be recommended while the fractured vertebra can still respond to balloon expansion. The balloon can lift the collapsed bone and restore some lost vertebral height. Once the fracture heals and hardens, vertebroplasty may be recommended when stabilization is needed without height restoration.

2. Current Symptoms

Your doctor may recommend treatment if an older fracture continues to cause severe pain in one area of your spine. Your doctor may also recommend a procedure when conservative treatments do not provide enough relief from chronic pain. In this case, your doctor will confirm that the pain originates from the fractured vertebra before recommending a surgical intervention.

3. Diagnostic Imaging

Your doctor may use MRI, CT, or a bone scan to assess healing and the fracture’s radiological outcome. These tests can show if the vertebra has healed in a collapsed position or still requires stabilization. Your doctor can then determine if kyphoplasty or vertebroplasty remains appropriate.

Consult Our Spine Specialist to Choose Between Vertebroplasty and Kyphoplasty!

A spinal fracture can cause persistent pain that limits your movement and interferes with everyday activities. As these problems continue, you may feel worried about your recovery and your ability to return to your usual routine. You may also feel uncertain about which procedure can provide the right treatment for your fracture.

At Total Orthopedics & Sports Medicine, our spine specialists evaluate your symptoms, imaging results, and vertebral fractures before recommending a procedure. We discuss the expected benefits, possible risks, procedure steps, and recovery for each option to support an informed treatment decision. We also provide a second opinion to confirm your diagnosis and treatment options. Call 855-321-6784 or visit our clinics in Syosset, Massapequa, East Meadow, or Deer Park for personalized fracture treatment.

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