Author: Flying Chimp

Kyphoplasty is procedure that’s been out now over 20 years. It involves treatment for fractures in the lower, mid back or low back that are unresponsive to non-surgical treatment. A needle is placed in the broken bone and through the needle. A balloon is passed. The balloon is inflated, and surgical cement is put into the fracture instantly fixing it.

For a while we thought that pretty much everybody with a fracture in these areas needed a kyphoplasty and as quick as a fashion possible. Now we know that it’s been out for a long enough time, has been studied that it’s not a procedure that should be done in everybody, but rather, certain cases that take longer to heal or, or patients with a fracture that collapses worse.

Spondylolisthesis just means slippage, and that’s where in the spine one bone is slipped on the other one vertebrae. So on one end it may just be something we see on X-ray that’s not really causing any problems. On the other end, if it’s very unstable, moving a lot, it could be something that requires timely surgical intervention.

Spinal fusion in the lumbar spine has been around for a long time. Frankly, for a while it was overperformed and still in some cases is overperformed. The surgeon has to be very selective about who he performs or she performs a lumbar fusion on, as the outcomes can vary greatly, in certain cases, there’s no choice, such as when the spine is unstable and the patient’s at risk for severe neurologic injury unless the spine becomes stabilized or in cases of fracture or stress fracture.

In other cases, often a less invasive procedure performed on an outpatient basis could be attempted first, and with that minimum intervention, you get the patient good enough where they don’t need the more aggressive fusion.

Patients very commonly come to me as a first time patient, worried that I’m gonna recommend surgery on the first visit. And that’s a very rare circumstance where there really are no other options. The vast majority of my patients, we start with routine medications, physical therapy, and take a slow progression towards more and more aggressive approaches if they need it.

The next step after therapy is typically injections. And then after they’ve tried everything else, if they’re not getting better and the pain’s bad enough and they have a good surgical option, then we go over their surgical options.

Spondylolisthesis just being slippage, and that’s where in the spine, one bone is slipped on the other one vertebrae. So on one end it may just be something we see on X-ray that’s not really causing any problems. On the other end, if it’s very unstable, moving a lot, it could be something that requires timely surgical intervention.