A vertebroplasty or kyphoplasty is a procedure where a surgeon injects bone cement into a fractured vertebra to stabilize it and reduce pain

These are minimally invasive procedures performed under imaging guidance—usually fluoroscopy or CT—that take 30 to 60 minutes per vertebra. The surgeon makes a small needle puncture in the skin over the fractured bone, threads a needle or catheter to the fracture site, and either injects cement directly (vertebroplasty) or first inflates a small balloon to restore height before injecting cement (kyphoplasty). The cement hardens within minutes, immediately stabilizing the bone and often providing pain relief the same day or within a few days.

Both procedures are outpatient treatments, meaning you go home the same day. They are used when compression fractures from osteoporosis cause severe pain that does not improve with rest, pain medication, or bracing over several weeks. Not every compression fracture needs this intervention—many heal on their own—but when a fracture is causing disability or the pain is not controlled by other means, these procedures can restore function and quality of life.

Key Takeaways

  • Vertebroplasty and kyphoplasty are same-day procedures that inject cement into a fractured vertebra to stabilize it and reduce pain.
  • Kyphoplasty uses a balloon to restore some of the height lost in the fracture before cement is injected; vertebroplasty injects cement directly.
  • These procedures are typically offered when pain from a compression fracture does not improve after several weeks of conservative treatment like rest and medication.
  • Recovery is usually quick—most people return to light activity within a few days, though strenuous activity is restricted for several weeks.
  • Risks are low but real, including cement leakage, infection, and in rare cases, nerve or blood vessel injury.

How the two procedures differ

Vertebroplasty is the simpler of the two. The surgeon uses imaging to guide a needle directly into the fractured vertebra and injects medical-grade cement (polymethylmethacrylate, or PMMA) to fill the fracture space. The cement hardens and locks the fracture in place. This procedure is faster and less expensive, but it does not restore the height that was lost when the vertebra collapsed.

Kyphoplasty adds a step: before injecting cement, the surgeon inflates a small balloon inside the fractured vertebra. This balloon pushes the bone fragments back toward their original position, restoring some of the lost height and reducing the forward curvature (kyphosis) that often develops after compression fractures. Once the balloon is deflated and removed, cement is injected into the space it created. Kyphoplasty takes longer and costs more, but it may reduce the risk of future fractures in adjacent vertebrae and can improve posture.

Your surgeon will recommend one or the other based on how much height was lost, how long ago the fracture occurred, and whether restoring height is a priority for your situation. Both are performed under local anesthesia with sedation, so you are awake but relaxed and do not feel pain during the procedure.

What to expect before, during, and after the procedure

Before the procedure: You will have imaging (X-rays or MRI) to confirm which vertebra is fractured and to rule out infection or tumor as the cause. Blood work may be done to check clotting and kidney function. You will be told to stop eating and drinking several hours before the procedure, similar to before surgery. Arrange for someone to drive you home, as sedation will make it unsafe to drive yourself.

During the procedure: You lie face down on a procedure table. The surgeon cleans the skin over the fracture site and injects local anesthetic. Using real-time imaging, they guide a needle or catheter into the fractured vertebra. If kyphoplasty, the balloon is inflated and then removed. Cement is then injected and hardens within minutes. You may feel pressure or a warm sensation but should not feel sharp pain. The whole procedure typically takes 30 to 60 minutes.

After the procedure: You spend one to two hours in recovery while the sedation wears off. Most people go home the same day with written instructions. Pain at the injection site is common for a few days and is managed with over-the-counter pain relievers or prescribed medication. You can usually return to light activity—walking, sitting, gentle stretching—within a few days. Heavy lifting, bending, and strenuous exercise are restricted for four to six weeks to allow the cement to fully set and the fracture to stabilize.

Who is a candidate for these procedures

These procedures are considered when a compression fracture is causing significant pain or disability and conservative treatment has not worked. Conservative treatment typically includes rest, pain medication (over-the-counter or prescription), muscle relaxants, and sometimes a back brace worn for several weeks. If pain is still severe after four to twelve weeks of conservative care, or if the fracture is causing progressive collapse or neurological symptoms, your doctor may recommend vertebroplasty or kyphoplasty.

You are not a candidate if the fracture is caused by infection (such as spinal tuberculosis), active cancer in the bone, or severe coagulopathy (bleeding disorder). Pregnancy is also a contraindication because of radiation exposure during imaging. If you have had a previous vertebroplasty or kyphoplasty at the same level, a repeat procedure at that exact spot is not done, though adjacent vertebrae can be treated if they fracture later.

Age alone is not a barrier. Older adults with osteoporosis are actually the most common candidates, and the procedure is safe in people in their 80s and 90s if they are otherwise healthy enough for outpatient surgery. Your surgeon will review your medical history, imaging, and current medications to determine whether the procedure is right for you.

Risks and complications

Serious complications are uncommon, occurring in fewer than 5 percent of procedures. The most frequent issue is cement leakage into surrounding tissue or the spinal canal. Most leaks cause no symptoms and are found only on imaging. Symptomatic leaks—those that press on nerves or blood vessels—are rare but can cause pain, numbness, or weakness and may require additional treatment.

Other risks include infection at the injection site or inside the vertebra (osteomyelitis), which is treated with antibiotics and sometimes drainage. Bleeding or bruising at the injection site is common and minor. Nerve or blood vessel injury is very rare because the surgeon uses imaging guidance throughout. Allergic reaction to the cement is extremely rare. Some people experience temporary increased pain immediately after the procedure before improvement begins.

A theoretical but unproven risk is that cement in one vertebra may increase stress on adjacent vertebrae and lead to new fractures nearby. This has not been consistently demonstrated in research, and the benefit of pain relief and restored function usually outweighs this concern. Your surgeon will discuss the specific risks relevant to your situation before you consent to the procedure.

Recovery and returning to normal activity

Most people experience significant pain relief within days of the procedure, though some notice improvement gradually over two to three weeks. The cement provides immediate mechanical support, but the body's own healing also continues. You should feel the difference in your ability to move, sit upright, and walk without severe pain.

During the first two weeks, avoid bending at the waist, twisting, or lifting anything heavier than 10 pounds. Sleep on your back or side, not on your stomach. Walking is encouraged and helps prevent blood clots. After four to six weeks, you can gradually return to normal activities, including light exercise like swimming or stationary cycling. Heavy lifting, contact sports, and high-impact activities should be avoided for at least three months.

Physical therapy is often recommended to rebuild strength in the back and core muscles, which helps prevent future fractures. Your surgeon will give you specific restrictions based on how many vertebrae were treated and your overall bone health. If you have osteoporosis, you will also be advised to start or continue osteoporosis medication (such as bisphosphonates) to slow further bone loss and reduce the risk of new fractures.

How to prepare for the conversation with your doctor

Before meeting with a spine surgeon or interventional radiologist, gather your recent imaging (X-rays, MRI, or CT scans) and a list of all medications and supplements you take, including blood thinners. Write down how long you have had pain, what makes it better or worse, and how it has affected your daily life—this information helps your doctor decide whether the procedure is timely.

Ask your doctor whether vertebroplasty or kyphoplasty is recommended for your specific fracture and why. Ask about the expected pain relief, how long recovery takes, and what restrictions you will have afterward. Ask about the risks specific to your situation and what happens if the procedure does not relieve your pain. Ask whether you need to stop any medications before the procedure, and whether you should continue osteoporosis treatment afterward.

If your first doctor recommends conservative treatment longer, that is often reasonable—many compression fractures do improve with time. But if pain is severe and affecting your function after several weeks, seeking a second opinion from a spine surgeon is appropriate. These procedures are well-established and safe, and they can make a real difference in quality of life when the right patient is selected.

Frequently Asked Questions

How long does pain relief last after vertebroplasty or kyphoplasty?

Most people experience lasting relief—studies show that 70 to 80 percent of patients have significant pain reduction that persists for years. However, if you develop new compression fractures in other vertebrae (which can happen with untreated osteoporosis), you may need additional procedures. Continuing osteoporosis medication reduces this risk.

Can I have the procedure if I am on blood thinners?

Yes, but your doctor needs to know. Depending on the blood thinner and the reason you take it, you may need to stop it temporarily before the procedure or adjust the dose. Do not stop blood thinners on your own—discuss the timing with both your primary care doctor and the surgeon performing the procedure.

What if the fracture is in my lower back instead of mid-back?

Vertebroplasty and kyphoplasty can be performed on fractures anywhere in the spine, including the lower back (lumbar spine). The procedure is the same; the surgeon simply accesses the fractured vertebra from a different angle. Lower back fractures may have slightly different recovery restrictions because the lumbar spine bears more weight.

Will I need surgery if the cement leaks?

Most cement leaks cause no symptoms and do not need treatment—they are found only on follow-up imaging. If a leak is pressing on a nerve and causing pain or weakness, your surgeon may recommend additional intervention, but this is uncommon. Your doctor will monitor you and explain what to watch for.

Can I have both vertebrae treated in one procedure if I have multiple fractures?

Yes. If you have fractures in two or three adjacent vertebrae causing pain, the surgeon can treat multiple levels in a single session. This reduces the total number of procedures and anesthesia exposure. The procedure takes longer, but recovery is similar to treating a single vertebra.