If you have been diagnosed with a vertebral compression fracture (VCF), your doctor may have mentioned kyphoplasty or vertebroplasty as treatment options. Both are minimally invasive procedures that stabilize fractured vertebrae using bone cement, but they differ in technique, outcomes, and candidacy. Understanding these differences will help you have a more informed conversation with your spine specialist.
Key takeaway
Kyphoplasty includes a balloon inflation step that can restore lost vertebral height before cement injection. Vertebroplasty injects cement directly without height restoration. Kyphoplasty may have a lower cement leakage rate. Both provide significant pain relief for the majority of patients.
How vertebroplasty works
Vertebroplasty is the simpler of the two procedures. Under fluoroscopic (live X-ray) guidance, a needle is inserted through a small skin incision into the fractured vertebra. Medical-grade bone cement (PMMA) is injected directly into the fracture to stabilize it. The cement hardens within minutes, providing immediate structural support.
The procedure takes approximately 30-45 minutes per level and is typically performed under local anesthesia with sedation. Most patients go home the same day.
How kyphoplasty works
Kyphoplasty includes an additional step before cement injection. After the needle is placed in the fractured vertebra, a small balloon (called a bone tamp) is inserted and gently inflated. This creates a cavity inside the vertebra and can restore some or all of the lost height caused by the fracture.
Once the balloon is deflated and removed, bone cement is injected into the cavity under lower pressure than vertebroplasty. The procedure takes approximately 30-60 minutes per level.
Key differences at a glance
Height restoration: Kyphoplasty can partially or fully restore vertebral height through balloon inflation. Vertebroplasty does not restore height — it stabilizes the fracture in its current state.
Cement leakage risk: Because kyphoplasty injects cement into a pre-formed cavity under lower pressure, the risk of cement leaking outside the vertebra may be lower than with vertebroplasty. Both procedures have low overall leakage rates.
Kyphosis correction: By restoring vertebral height, kyphoplasty can help correct the forward-leaning posture (kyphosis) that develops after compression fractures. This has implications for balance, breathing, and long-term spinal alignment.
Cost: Kyphoplasty is generally more expensive than vertebroplasty due to the balloon device. Both are covered by most insurance plans and Medicare when medically indicated.
Pain relief: Both procedures provide significant pain relief in the majority of patients. Clinical studies show comparable pain reduction outcomes between the two techniques.
Who is a better candidate for each?
Kyphoplasty may be preferred when:
- The fracture is relatively recent (within 2-8 weeks) and height restoration is still possible
- There is significant height loss or kyphotic deformity to correct
- The patient has multiple compression fractures affecting spinal alignment
- Lower cement leakage risk is clinically important (e.g., fractures near the spinal canal)
Vertebroplasty may be preferred when:
- The fracture is older and the vertebra has already consolidated
- Height restoration is not a primary goal (minimal height loss)
- A simpler, shorter procedure is desired
- Cost is a significant consideration
What the research says
Multiple clinical studies and meta-analyses have compared kyphoplasty and vertebroplasty. The consensus findings suggest that both procedures are effective and safe, with kyphoplasty showing a modest advantage in height restoration and cement leakage rates, and comparable results in pain relief and functional improvement.
The most important factor in outcomes is not which procedure you choose, but whether you are treated by an experienced specialist who performs these procedures regularly and can select the right technique for your specific fracture pattern.
Not sure which procedure is right for you?
Our spine specialists perform both kyphoplasty and vertebroplasty and will recommend the approach best suited to your specific fracture. Same-week consultations available.
Call (714) 598-1745Questions to ask your doctor
When discussing treatment for a vertebral compression fracture, consider asking:
- Is my fracture recent enough that height restoration is still possible?
- How much height have I lost, and will kyphoplasty meaningfully restore it?
- What is your experience level with both procedures?
- Are there specific features of my fracture that make one approach clearly better?
- What is the pre-authorization and scheduling timeline?