Kyphoplasty, Vertebroplasty & Sacroplasty Explained

Vertebral augmentation is a group of minimally invasive procedures that use bone cement to stabilise a painful fractured bone in the spine or pelvis. The three most common forms — vertebroplasty, kyphoplasty and sacroplasty — share the same underlying idea but differ in technique and location. This page explains how they work, who they may suit, and their balance of benefits and risks, to support an informed conversation with a spine specialist.

What are kyphoplasty, vertebroplasty and sacroplasty?

All three procedures treat a broken bone by injecting a medical-grade cement that hardens to provide internal support. They are performed through a needle, guided by live X-ray or other imaging, rather than through an open incision.

• Vertebroplasty injects bone cement directly into a fractured vertebra to stabilise it.
• Kyphoplasty first inflates a small balloon inside the fractured vertebra to create a cavity, which may help restore some lost height, before the cavity is filled with cement. This is why it is sometimes called balloon kyphoplasty.
• Sacroplasty uses the same cement principle to treat a painful fracture of the sacrum, the wedge-shaped bone at the base of the spine.

The shared aim is to reduce the pain that arises when a broken bone moves, by holding the fracture steady from within. Collectively these techniques are described as vertebral augmentation.

Who is a candidate? (Indications)

These procedures are most often considered for painful fractures that have not settled adequately with non-surgical care.

Typical situations include:

• Osteoporotic compression fractures of a vertebra, where weakened bone has collapsed and causes significant pain.
• Sacral insufficiency fractures, again usually linked to osteoporosis, causing pain at the base of the spine or pelvis.
• Fractures weakened by tumour, in selected cases, to stabilise the bone and relieve pain.
• Persistent, fracture-related pain that limits movement despite a reasonable period of pain relief, bracing and graded activity.

Careful assessment is needed to confirm that the pain truly comes from the fracture and to rule out other causes. Many fractures heal well without augmentation, so the decision is made on an individual basis.

How the procedure is performed

Vertebral augmentation is usually carried out under local anaesthetic with sedation, or sometimes general anaesthetic. The broad steps are:

1. The patient is positioned, commonly face down, and the skin over the fracture is cleaned and numbed.
2. Under live X-ray or imaging guidance, a needle is passed through the skin into the fractured bone.
3. In kyphoplasty, a balloon is inflated through the needle to create a cavity and may help lift the collapsed bone; the balloon is then removed.
4. Bone cement is injected into the bone, or into the prepared cavity, under continuous imaging to watch its spread.
5. The cement is allowed to set and harden, providing internal support to the fracture.
6. The needle is removed and a small dressing applied; no large incision or stitches are usually needed.

Minimally invasive nature

These are minimally invasive procedures by design. Access is through a needle puncture rather than a surgical cut, muscle is not divided, and imaging guides every step. As a result they are often performed as a day case or with a short stay, and recovery from the procedure itself is generally quick.

The minimally invasive route does not change the importance of careful patient selection. Imaging guidance is central to placing the cement safely and to reducing the chance of it spreading where it is not wanted.

Benefits and risks

As with any procedure, the potential benefits must be weighed against the recognised risks.

Potential benefits

• Stabilisation of a painful fracture from within the bone.
• Reduction of fracture-related pain, which may help earlier return to movement.
• A minimally invasive technique with no large wound and a short procedure time.

Recognised risks

• Cement leakage outside the bone, which can occasionally irritate nearby nerves.
• Infection or bleeding.
• Rarely, cement entering the bloodstream.
• A new fracture at an adjacent level over time, particularly where bone is weak.
• Incomplete pain relief, as not all pain may come from the treated fracture.

A specialist will explain how these risks apply to an individual situation.

Alternatives

Augmentation is one option, and non-surgical care remains the first step for many fractures.

• Conservative management — pain relief, a short period of relative rest, bracing and a graded return to activity, which allows many fractures to heal.
• Treatment of the underlying bone weakness — medication for osteoporosis, calcium and vitamin D, and falls prevention.
• Open surgery with instrumentation, reserved for unstable fractures, deformity or neurological involvement, which augmentation alone does not address.

The right choice depends on the type of fracture, its stability and the person’s overall health.

Recovery and outlook

Because these are minimally invasive procedures, many people are able to get up within hours and go home the same day or after a short stay. Some notice an early reduction in pain, although responses vary and not everyone experiences the same degree of relief.

Importantly, augmentation treats the fracture but not its cause. Continuing to manage osteoporosis is essential to reduce the risk of further fractures, and a specialist will usually arrange or recommend bone-health treatment alongside the procedure. Gentle, graded activity and falls prevention support a good long-term outcome.

When to seek a specialist opinion

Seek medical advice if you develop sudden, severe back pain after a minor injury or even without obvious cause, especially if you have osteoporosis or are at risk of it. Pain that remains severe despite a period of non-surgical care, or that limits your ability to move, also warrants assessment.

Any new leg weakness, numbness, or loss of bladder or bowel control alongside back pain should prompt urgent medical attention. A specialist can confirm whether the pain comes from a fracture, advise on bone-health treatment, and explain whether vertebral augmentation is appropriate.