How vertebroplasty and kyphoplasty work
A percutaneous procedure — meaning a needle is inserted through the skin — can stabilize a compression fracture in your spine caused by osteoporosis. The two main types are vertebroplasty and kyphoplasty. In vertebroplasty, a surgeon injects bone cement directly into the fractured vertebra to harden it and stop the pain. In kyphoplasty, a small balloon is first inflated inside the vertebra to create space and restore some height, then the cement is injected.
Both procedures take 30 to 60 minutes per vertebra and are usually done under local anesthesia with sedation, so you stay awake but relaxed. The surgeon uses imaging (X-ray or CT) to guide the needle to the exact spot. Most people go home the same day or the next morning.
These procedures do not treat the underlying osteoporosis — they treat the fracture itself. You will still need osteoporosis medication and lifestyle changes to prevent future fractures.
Key Takeaways
- Vertebroplasty and kyphoplasty are needle-based procedures that inject cement into a fractured vertebra to reduce pain and stabilize the bone.
- Kyphoplasty uses a balloon first to restore some height to the vertebra, while vertebroplasty injects cement directly without that step.
- Both procedures take 30 to 60 minutes per vertebra and are usually same-day or next-day discharge.
- These procedures treat the fracture pain but do not reverse osteoporosis, so you will continue medication and bone-strengthening activities afterward.
- Your doctor will order imaging and run blood tests to confirm you are a candidate and that the fracture is recent enough to benefit.
When these procedures are considered
Your doctor may suggest vertebroplasty or kyphoplasty if you have a compression fracture that is causing severe pain and limiting your movement, and if the fracture happened within the last few months. The procedure works best on fresh fractures — typically within 6 to 12 months of the break, though timing varies by surgeon and your overall health.
You are usually a candidate if you can lie still on your stomach for the procedure and if imaging shows the fracture is in the vertebral body (the main part of the bone) rather than in the back part of the vertebra. Your surgeon will also check that you do not have an active infection or bleeding disorder that would make the procedure unsafe.
If your pain is mild or manageable with physical therapy and pain medication, your doctor may recommend waiting and treating conservatively first. Some fractures heal on their own over 8 to 12 weeks with rest, bracing, and exercise.
What happens before the procedure
Your doctor will order an MRI or CT scan to see the fracture clearly and confirm it is suitable for treatment. Blood tests check your clotting ability and kidney function. You will meet with the surgeon to discuss which vertebra needs treatment, what to expect during the procedure, and what pain relief you can expect afterward.
Tell your surgeon about all medications you take, especially blood thinners like warfarin or aspirin. You may need to stop these several days before the procedure. Do not eat or drink after midnight the night before, just as with any procedure involving sedation.
Arrange for someone to drive you home, since you will have received sedation. Plan to rest for the first 24 hours — no heavy lifting, bending, or strenuous activity.
Recovery and what to expect after
Most people feel pain relief within a few days to a week after the procedure. Some feel better when ready, while others notice improvement more gradually. You may have soreness at the injection site for a few days — this is normal and usually managed with over-the-counter pain medication or ice.
You can return to light activities like walking and gentle stretching within a few days. Avoid heavy lifting (more than 10 pounds), bending forward sharply, or twisting for at least 4 to 6 weeks. Your surgeon will give you specific restrictions based on how many vertebrae were treated and your overall bone health.
Physical therapy often begins within 1 to 2 weeks after the procedure. A physical therapist will teach you exercises to strengthen your core, improve balance, and prevent falls — all critical for preventing future fractures. Stick with these exercises even after you feel better; they are your main defense against another break.
Risks and limitations
Vertebroplasty and kyphoplasty are generally safe, but like any procedure they carry some risk. Cement can leak outside the vertebra into the spinal canal or bloodstream, though this is rare and usually causes no symptoms. Infection at the injection site is uncommon but possible. A small number of people experience increased pain after the procedure, or the fracture does not stabilize as expected.
The procedures do not stop osteoporosis from progressing. You can develop new compression fractures in other vertebrae, especially if you do not take bone-strengthening medication or make lifestyle changes. Some studies suggest that treating one fracture may slightly increase the risk of fracture in the vertebra directly above or below it, though this is debated.
These procedures are not recommended if you are pregnant, have an active infection, or cannot lie still during the procedure. They are also less effective on very old fractures (more than 12 to 18 months old) because the bone has already started to heal in a collapsed position.
Cost and insurance coverage
Vertebroplasty and kyphoplasty costs vary widely depending on your location, hospital, and how many vertebrae are treated. The procedure itself, facility fees, anesthesia, and imaging all add to the total. Most insurance plans, including Medicare, cover these procedures when performed for osteoporosis-related compression fractures that meet specific criteria — usually pain that has not improved with conservative treatment for 4 to 12 weeks.
Contact your insurance company before scheduling to confirm coverage and ask about your out-of-pocket costs. Ask the surgeon's office for an estimate of what your insurance will be billed and what you may owe. Some hospitals offer financial information programs if cost is a barrier.
Alternatives to consider
Conservative treatment — rest, bracing, pain medication, and physical therapy — is often the first step. Many compression fractures improve significantly over 8 to 12 weeks without surgery. A back brace can reduce pain and limit movement while the bone heals, though wearing one for too long can weaken your core muscles.
Stronger pain medication, including prescription opioids, can help you stay active while healing. Physical therapy and balance training reduce fall risk and build strength. Osteoporosis medication (bisphosphonates, denosumab, or other drugs) slows bone loss and can prevent new fractures.
If one vertebra is severely collapsed and causing nerve pressure or deformity, your surgeon may recommend open spinal fusion surgery instead of a percutaneous procedure. This is more invasive but may be necessary if the fracture is very old or if multiple vertebrae are involved.
Frequently Asked Questions
How long does pain relief last after vertebroplasty?
Most people experience lasting relief — studies show 70 to 80 percent of patients have significant pain reduction that persists for years. However, if you develop a new compression fracture in another vertebra, you may need another procedure. Pain relief depends on whether you continue osteoporosis treatment and fall prevention.
Can I have the procedure done on multiple vertebrae at once?
Yes, surgeons can treat two or three vertebrae in a single session, though each one adds 30 to 60 minutes to the procedure time. Treating multiple levels increases the time under sedation and may extend recovery slightly. Your surgeon will discuss whether doing them all at once or in separate sessions makes sense for you.
Will I need physical therapy after the procedure?
Physical therapy is strongly recommended and usually starts 1 to 2 weeks after the procedure. A therapist will teach you core strengthening, balance exercises, and safe movement patterns. These exercises are essential for preventing future fractures and improving your overall function and confidence.
What if the procedure does not relieve my pain?
If pain does not improve after 4 to 6 weeks, talk to your surgeon. Sometimes additional imaging shows the fracture was not the main source of pain, or another issue (like arthritis or muscle strain) is contributing. Your surgeon may recommend stronger medication, more intensive physical therapy, or in rare cases, a second procedure or open surgery.
Can I travel after vertebroplasty?
You can travel once you feel ready, usually within 1 to 2 weeks. Avoid long car or plane trips in the first few days — sitting for extended periods can be uncomfortable. When you do travel, take breaks to stand and stretch, wear your back brace if prescribed, and pack pain medication. Avoid heavy lifting of luggage.