Kyphoplasty vs Vertebroplasty: What You Need to Know About Vertebral Fracture Treatment

When a vertebra collapses due to osteoporosis, trauma, or cancer, the pain can be unbearable. Standing, sitting, even breathing becomes a struggle. For many, conservative treatments like rest, painkillers, or back braces don’t cut it. That’s where kyphoplasty and vertebroplasty come in - two minimally invasive procedures that can restore mobility and bring relief in hours, not weeks.

Both procedures fix broken spinal bones using medical-grade bone cement. But they’re not the same. One uses a balloon to lift the bone before filling it. The other injects cement directly. Knowing the difference matters - because your fracture, your body, and your goals determine which one is right for you.

How These Procedures Work

Imagine a bone in your spine that’s been crushed, like a soda can stepped on. It’s painful, unstable, and often misshapen. Kyphoplasty and vertebroplasty both aim to stabilize it, but they take different paths.

Vertebroplasty is the older method. A doctor inserts a thin needle through your skin and into the fractured vertebra, guided by real-time X-ray. Then, they inject liquid bone cement - polymethylmethacrylate, or PMMA - directly into the crack. The cement hardens in 10 to 20 minutes, locking the bone fragments together. It’s quick, usually taking 30 to 60 minutes per level. Most patients go home the same day.

Kyphoplasty adds a step. Before injecting cement, a small balloon is threaded into the fracture. It’s inflated gently with saline, lifting the collapsed bone back toward its original height. Once the balloon is deflated and removed, the space it created is filled with cement. This extra step doesn’t just stabilize - it can restore some of the spine’s natural curve.

Both procedures use local anesthesia and IV sedation. You’re awake but relaxed. No large incisions. No long hospital stays. Recovery starts immediately.

Key Differences: Height Restoration and Cement Leakage

The biggest difference between the two isn’t pain relief - both deliver it. It’s what happens inside the bone.

Kyphoplasty can restore 40% to 60% of lost vertebral height. That’s important if your spine has developed a noticeable hunch (kyphosis). Restoring height can improve posture, reduce pressure on other vertebrae, and even help with breathing. But here’s the catch: studies show that some of this height gain fades over time. After 500 loading cycles (roughly equivalent to months of normal activity), you might lose about 30% of the restored height. Still, even partial restoration can make a real difference in daily life.

Vertebroplasty doesn’t try to lift the bone. It just fills the space. So if your fracture is stable and not causing a visible curve, it works just as well for pain relief.

Then there’s cement leakage - a risk in both procedures. With vertebroplasty, cement can leak out of the bone into surrounding tissues. Studies show leakage happens in 27% to 68% of cases. Most leaks cause no symptoms. But in about 1.1% of cases, it presses on nerves or travels to the lungs, causing serious problems. Kyphoplasty reduces this risk. The balloon creates a controlled cavity, so cement is injected under lower pressure. Leakage drops to 9% to 33%. Symptomatic leaks are rare - just 0.6% of kyphoplasty cases.

How Much Pain Relief Can You Expect?

Here’s the good news: both procedures deliver fast, powerful pain relief.

Before the procedure, patients typically rate their pain at 8.2 out of 10. Within 24 hours, that number drops to 1.5 on average. That’s an 85% to 90% reduction. Most people say it feels like a switch was flipped.

Patients on Healthgrades rate kyphoplasty 4.6/5 and vertebroplasty 4.4/5. On forums, people describe it as "instant relief," "life-changing," or "I can finally sleep again."

But pain relief isn’t guaranteed for everyone. About 10% to 15% of patients still have discomfort afterward. Why? Maybe the fracture was too old. Maybe other spine issues are involved. Or maybe the cement didn’t spread evenly. That’s why MRI is required before either procedure - to confirm the fracture is still active, with inflammation in the bone marrow. If it’s an old, healed break, these procedures won’t help.

Cost, Recovery, and Who Pays

Kyphoplasty costs 20% to 30% more than vertebroplasty. In 2023, Medicare paid about $3,850 for kyphoplasty and $2,950 for vertebroplasty. That’s because of the balloon device - a single-use, specialized tool that adds to the price.

But cost isn’t just about the procedure. Recovery matters too. Most patients walk the same day. They’re off painkillers within a week. Studies show 75% stop using opioids after the procedure. Normal activities return within 1 to 2 weeks.

Medicare and most private insurers cover both procedures - if you’ve tried conservative treatment first. That means at least 4 to 6 weeks of rest, physical therapy, and pain medication without improvement. Approval rates are over 95% when paperwork is complete.

Who Gets Which Procedure?

Doctors don’t pick one over the other based on preference. They pick based on your fracture.

If your fracture has caused a visible hunch in your spine - more than 30% height loss - kyphoplasty is usually preferred. The balloon gives you a shot at correcting the deformity. It’s also better for patients with weak, crumbly bone, because the cavity reduces cement leakage risk.

If your fracture is stable, with little to no height loss, vertebroplasty is often the better choice. It’s cheaper, faster, and just as effective for pain relief. Experts like Dr. Richard Jensen argue that for these cases, the extra cost of kyphoplasty doesn’t justify the outcome.

Age matters too. Over 85% of these procedures are done on people 65 and older. Women make up 70% to 75% of cases - because osteoporosis hits them harder. But men with fractures from trauma or cancer benefit just as much.

What to Expect Before and After

You’ll need an MRI within the last 6 weeks to confirm the fracture is active. X-rays and CT scans help too, but MRI shows the bone marrow inflammation that tells doctors this is a fresh injury.

On the day of the procedure, you’ll lie face down. A needle goes in, guided by live X-ray. The whole thing takes less than an hour. You’ll be monitored for 4 to 6 hours afterward. You can’t drive home, so bring someone.

For the first 24 hours, avoid lifting anything heavier than a coffee cup. No twisting. No bending. After that, you can gradually increase activity. Most people are back to light chores by day three. Full recovery takes 1 to 2 weeks.

Some patients develop new fractures nearby within a year. That happens in 5% to 10% of cases. It’s not because the procedure caused it - it’s because osteoporosis is still there. That’s why long-term management matters: calcium, vitamin D, and bone-strengthening meds like bisphosphonates.

The Future of Spinal Fracture Care

Newer cement types are coming. Calcium phosphate cements mimic natural bone better and generate less heat during hardening, reducing tissue damage. Medtronic’s updated balloon system got FDA approval in March 2023.

A major 2023 study in The Lancet found that doing either procedure within two weeks of the fracture cut 12-month death risk by 28%. That’s huge. It suggests these aren’t just pain fixes - they might save lives by getting people moving again.

Right now, kyphoplasty makes up about 65% of procedures in the U.S. But analysts predict that will rise to 75% by 2028. Why? Better safety, more devices, and growing awareness.

Still, the bottom line hasn’t changed: if you have a painful, fresh vertebral fracture, both procedures work. The choice isn’t about which is "better." It’s about which fits your fracture, your body, and your life.