What is kyphoplasty, what is vertebroplasty, when should these procedures be considered?

[Music] what is kyphoplasty and invertible plasti in half a plasti you it's an outpatient procedure it's a very elegant procedure to get rid of the pain due to fractures in your spine so what you do is you insert a needle in the vertebral body and you inflate a balloon and the balloon elevates the upper and lower plate of the vertebral body and you fill the balloon with cement and the cement and the balloon stays in that area and you remove the needle and the vertebral body is stabilized by the cement foot in the balloon so it's a very I would say safe procedure the difference between Kappa plus T and vertebroplasty is that in vertebroplasty you just put the needle in and you inject the cement the disadvantage is you are missing the balloon that gives you a cavity in which you put the cement in and invertible press T you can have a leak of the cement adjacent to the vertebral body so I would not recommend about of a plasti to my patients I would if I consider this method I would always give the kyphoplasty both kyphoplasty invertebrates plus T is when there's a fracture mostly in the vertebrae in the vertebral body then the vertebral body is lower than it's supposed to be so it's kind of breaking breaking down and with with capability very first vertebroplasty they're basically very similar it's just a little bit change of the technique you go in with the needle into this area where there's the fracture you inflate a balloon which does not really add too much of height to the vertebral body but at least if there's not much bone left then it kind of compresses the bone at the margins of the vertebral body which kind of increases the density in the areas where it's most important for the stability and then this area that is where the balloon was the balloon is gone out and then it is filled with bone cement this is all under anesthesia the bone cement has the effect that it's when it's hardening then it becomes hot and it cooks the nerve endings there and it helps with pain there's a lot of discussion going into is it only a paint it's definitely a pain treatment and about 60% of patients have either benefit or even the pain disappears completely some patients don't have a benefit and we are not really sure which one we cannot really predict which ones will benefit in nutrients we're not so we rather recommend it because the side effects are very low and the risk is very low this this cooking of the nerve endings and taking care of pain that's the major thing of kyphoplasty inverter publicity when should these procedures be considered we do it with patients who have major pain from vertebral fractures there's a slight concern that you might have increased fractures above and below the vertebral bodies because those vertebral bodies are still soft from the myeloma and they adjacent to a very hard cement filled vertebral body and you might have an increased risk of fracturing the vertebral bodies adjusted soft above and below the cement-filled vertebral body so that is I would say a minor concern I would consider patients for kyphoplasty really with major vertebral fractures and pain and who do not really tolerate pain medication and do not have a benefit with reduced pain from chemotherapy [Music]