Dr. Charla Fischer, a board‑certified orthopedic spine surgeon in New York City, performs both kyphoplasty and vertebroplasty for painful spinal compression fractures. Here is how the two procedures work, how they differ, and who is likely to benefit.
What Is a Spinal Compression Fracture?
A compression fracture is a break in the vertebral body, the thick, oval-shaped front part of a vertebra. Most are caused by osteoporosis. Cancer that has weakened a vertebra is another cause. You can read more in Dr. Fischer’s posts on osteoporosis and spinal fractures and on telling a spinal fracture from a back strain.
How Vertebroplasty Works
In vertebroplasty, bone cement is injected into the fractured vertebra through a hollow needle. The needle is guided with live X-ray imaging (fluoroscopy), and the cement hardens quickly, typically within about 20 minutes. This stabilizes the broken bone.
How Kyphoplasty Works
Kyphoplasty adds one step: a small balloon. The balloon is passed through the needle into the fractured vertebra and inflated to create a space and help restore the bone’s height. The balloon is removed and the space is filled with cement. As Dr. Fischer describes it on her osteoporotic fracture page, kyphoplasty differs because she expands the bone with a balloon and restores the height of the bone in addition to using the cement.
Kyphoplasty vs. Vertebroplasty at a Glance
| Vertebroplasty | Kyphoplasty | |
|---|---|---|
| What’s done | Cement injected directly into the fracture | Balloon creates a space first, then cement fills it |
| Height restoration | Not the goal | Aims to restore some lost height |
| Cement leakage | More common in studies | Less common in studies |
| Pain relief | Similar for both in the research reviewed | Similar for both in the research reviewed |
| Anesthesia and time | Local anesthesia, often with sedation; usually under an hour | Local anesthesia, often with sedation; usually under an hour |
Which One Is Better?
Both are considered safe and effective, and the choice depends on the fracture. A published review comparing the two found similar pain relief. Kyphoplasty showed better-documented improvement in function and a lower rate of cement leakage (about 8% versus 40% in the studies reviewed). Most leaks cause no symptoms. The same review found that early height gains from kyphoplasty did not always last. Dr. Fischer recommends the approach based on the fracture’s shape, how recent it is, and the patient’s overall health.
Who Is a Good Candidate?
- Painful compression fractures from osteoporosis or from cancer that has weakened a vertebra.
- Older or frail patients whose ability to heal is reduced.
- Recent fractures: the procedures work best when done within about eight weeks of the fracture.
They are generally not recommended for healthy younger patients, for fractures that have already healed, for herniated discs, or for back pain that isn’t caused by a fracture. For fractures that make the spine unstable, Dr. Fischer also performs lumbar vertebral body replacement, in which the fractured part of the vertebra is replaced with a small cage and bone graft.
Recovery
Both procedures are done through a small needle puncture, not an open incision. Most people can walk about an hour afterward, and pain relief often comes almost immediately or within a few days. Normal activities resume gradually. Heavy lifting is avoided for about six weeks. Studies report that about 75% of patients regain lost mobility and become more active.
Risks
These are low-risk procedures, but not risk-free. Cement can leak outside the vertebra. This is usually harmless, but can cause problems if it reaches the spinal canal or blood vessels. Infection is rare (less than 1 in 1,000). Other risks include bleeding, increased pain, and nerve symptoms. About 10% of patients go on to have another compression fracture, which is why bone health still matters after the fracture is treated.
How to Get Help
If you have a new or worsening compression fracture, an evaluation can show whether kyphoplasty, vertebroplasty or another treatment is the right fit. Dr. Fischer sees patients at NYU Langone Center for Musculoskeletal Care, 333 East 38th Street, 6th Floor (646-501-7200), and NYU Langone Madison Orthopedic Surgery Associates, 145 East 32nd Street, 4th Floor (212-427-3986). Contact Dr. Fischer to schedule an evaluation.
Sources: RadiologyInfo.org (ACR/RSNA), Vertebroplasty and Kyphoplasty (reviewed June 2026); McCall T, Cole C, Dailey A. Vertebroplasty and kyphoplasty: a comparative review of efficacy and adverse events. Curr Rev Musculoskelet Med. 2008; Dr. Fischer’s osteoporotic fracture page.
Frequently Asked Questions
Is kyphoplasty the same as vertebroplasty?
They are closely related. Both inject bone cement into a fractured vertebra through a hollow needle. Kyphoplasty adds a step: a balloon is inflated inside the vertebra first to create space and help restore height, and the cement fills that space.
How long does kyphoplasty take?
Both kyphoplasty and vertebroplasty are usually completed within about an hour, using local anesthesia and often moderate sedation. Most people are able to walk about an hour afterward.
How soon does kyphoplasty relieve pain?
Pain relief often comes almost immediately or within a few days. Studies report that about 75 percent of patients regain lost mobility and become more active.
Who should not have kyphoplasty or vertebroplasty?
They are generally not recommended for healthy younger patients, for fractures that have already healed, for herniated discs, or for back pain that isn’t caused by a compression fracture.
Can I get another fracture after kyphoplasty?
It is possible. About 10 percent of patients develop another compression fracture, which is why bone health remains important after the treated fracture has healed.