At a glance
Vertebroplasty and kyphoplasty are minimally invasive spine procedures that stabilise a fractured vertebra (a broken spinal bone) by injecting medical-grade bone cement directly into the damaged bone. Both procedures are done through a needle, so no large incision is needed.
In vertebroplasty, cement is injected straight into the collapsed vertebra to harden it and stop it from moving. Kyphoplasty adds one step: before the cement goes in, a small balloon is inflated inside the bone to create space and partially restore the vertebra's original height. Once the balloon is removed, the cement fills that cavity. Both approaches aim to relieve pain and prevent the fracture from collapsing further.
Medical Condition
These procedures are used when a vertebral compression fracture (a collapse of the front part of a spinal bone) is causing significant pain that does not improve with rest, pain relief, or a back brace after several weeks. The fracture is almost always confirmed by imaging such as MRI or CT before the procedure is offered.
- Osteoporosis (thinning of the bones) that has led to one or more compression fractures
- A spinal fracture caused by cancer that has spread to the spine (spinal metastasis)
- A fracture from multiple myeloma (a cancer that weakens bones from within)
- Acute traumatic fracture of the spine in carefully selected patients
- Persistent, disabling back pain lasting more than four to six weeks despite non-surgical treatment
These procedures are not suitable for everyone. Your doctor will consider them unsuitable in the following situations.
- The fracture is old, fully healed, and the bone is stable
- There is an active infection in the spine or elsewhere in the body
- The spinal canal is significantly narrowed, putting the spinal cord at risk
- Nerve damage or paralysis is already present from the fracture
- The patient has an uncorrectable bleeding disorder
- The patient is allergic to the cement or contrast dye used in the procedure
Risks & Complications
Serious complications from vertebroplasty and kyphoplasty are uncommon, but all medical procedures carry some risk, and your doctor will discuss these with you beforehand.
- Cement leakage: a small amount of cement escaping into nearby tissues, the spinal canal, or blood vessels; usually harmless but occasionally causes nerve irritation or, rarely, blockage
- Temporary increase in back pain in the first day or two after the procedure
- Infection at the needle entry site or, rarely, deeper in the spine
- Bleeding at the puncture site
- New fracture in an adjacent vertebra, which may occur weeks or months later as the spine adjusts
- Allergic reaction to the contrast dye used to guide the needle under X-ray
- Nerve or spinal cord injury, very rare, related to cement leakage into the spinal canal
- Risks related to sedation or anaesthesia, such as breathing difficulty or medication reaction
- Blood clot in the legs (deep vein thrombosis) in patients who remain immobile
Preparation & Procedure
Preparation starts days before the procedure, not on the morning of it. Blood thinners, including aspirin and anti-inflammatory medications, are usually paused for several days beforehand because they raise the risk of bleeding. Your doctor or nurse will give you specific instructions on which medications to stop and for how long, and will also ask about any allergies, especially to contrast dye or iodine.
Patients are typically asked to stop eating and drinking for at least six hours before the procedure if sedation or general anaesthesia is planned. Smoking slows bone healing, so patients who smoke are advised to stop as early as possible before and after. Alcohol should be avoided in the days leading up to the procedure.
Several tests are usually done beforehand to plan the procedure and check that it is safe. These typically include the following.
- MRI of the spine to confirm the fracture is recent and identify exactly which vertebra is involved
- CT scan if MRI is not available or to get more detail about the bone structure
- Blood tests to check clotting function and kidney health (the contrast dye is filtered by the kidneys)
- Chest X-ray and an EKG (heart tracing) if general anaesthesia is planned
- A bone density scan (DEXA scan) if osteoporosis has not been formally diagnosed yet
On the day of the procedure, the steps usually follow this order.
- 1. You change into a hospital gown and a cannula (a small tube) is placed in your arm for fluids and medication.
- 2. You lie face-down on a procedure table so the surgeon can access the back of the spine.
- 3. Sedation or local anaesthetic is given to numb the skin and deeper tissues around the target vertebra. General anaesthesia is used in some hospitals or for anxious patients.
- 4. Using live X-ray (fluoroscopy) or CT guidance, the surgeon inserts a hollow needle through the skin into the fractured vertebra.
- 5. For kyphoplasty, a small balloon (called a bone tamp) is threaded through the needle and inflated to open a cavity inside the bone. The balloon is then deflated and removed.
- 6. Liquid bone cement is injected through the needle to fill the cavity. The cement sets firm within minutes.
- 7. The needle is removed, and a small dressing is applied to the skin entry point.
- 8. You are moved to a recovery area and monitored until the sedation wears off.
Aftercare
Most patients are monitored in a recovery room for one to two hours after the procedure, and many go home the same day or after one night in hospital. Pain relief often improves noticeably within the first few days, though some soreness around the needle entry site is normal. Your care team will guide you on returning to activity, as the pace varies depending on how many vertebrae were treated, your overall health, and the underlying cause of the fracture.
- Lying flat and resting for the first few hours after the procedure is standard; nurses will help you sit up and walk when it is safe
- Heavy lifting, bending, and twisting are typically avoided for several weeks while the treated area settles
- The small skin puncture needs only a simple dressing, which is usually kept dry for one to two days
- Blood thinners or other paused medications are restarted on a schedule your doctor sets, not automatically on the day after
- A follow-up appointment is usually arranged within two to four weeks to check imaging and assess pain levels
- If osteoporosis caused the fracture, treatment for bone density, such as medications and calcium supplementation, is normally started or reviewed at the follow-up
- Cancer patients will continue their oncology (cancer) treatment plan alongside spinal recovery
- Contact the hospital promptly if new numbness, weakness in the legs, loss of bladder or bowel control, fever, or worsening pain develops after going home
Cost & What Determines It
The cost of vertebroplasty or kyphoplasty varies widely from one hospital and country to the next, because the final bill is shaped by many factors specific to spine procedures of this kind.
- Procedure type: kyphoplasty is generally more expensive than vertebroplasty because it uses a balloon device that adds to the material cost
- Number of vertebrae treated: treating two or three fractured levels in a single session increases operating time and material use compared with treating one
- Hospital class: a university hospital or internationally accredited facility charges differently from a community or regional hospital
- Country of treatment: labour costs, equipment import costs, and facility fees differ significantly between countries
- Anaesthesia type: local anaesthetic with light sedation costs less than full general anaesthesia, which requires an anaesthesiologist and dedicated monitoring
- Imaging guidance used: CT-guided placement involves different equipment charges than fluoroscopy (live X-ray)
- Length of stay: a same-day procedure with discharge by evening costs less than a one-night or multi-night admission
- Pre-procedure investigations: MRI, CT, blood tests, and bone density scans are often billed separately from the procedure itself
- Underlying disease complexity: cancer-related fractures may require additional imaging, biopsy, or specialist consultations that add to the total
- Post-procedure medication: pain relief, antibiotics for infection prevention, and any new bone-strengthening drugs are usually itemised separately
Hospital packages for vertebroplasty or kyphoplasty typically cover the surgeon's fee, the procedure room, the cement and needle materials, nursing care during the stay, and a routine post-procedure X-ray. Items that are often billed separately include the pre-admission MRI or CT, anaesthesiologist fee, pathology if a biopsy is taken, additional nights in a ward or private room, physiotherapy sessions, and specialist consultation fees outside the operating team.
Indonesian patients travelling abroad for this procedure should know that BPJS Kesehatan does not cover treatment received outside Indonesia, and most domestic private insurance policies also exclude overseas care. Most patients therefore pay out of pocket or use a private international health insurance plan that explicitly covers medical travel. Before booking any trip, ask the hospital for a written cost estimate that lists every expected charge, including consultations, imaging, and the procedure itself, so that there are no unexpected bills on discharge.
Frequently Asked Questions
How many sessions does vertebroplasty or kyphoplasty take?
Most patients need only one session to treat a fractured vertebra (a broken spinal bone). The procedure is done in a single visit, usually taking between 45 minutes and two hours depending on how many vertebrae need to be treated.
What does vertebroplasty or kyphoplasty feel like during and after the procedure?
During the procedure you will be sedated or given local anaesthesia (numbing medicine injected near the spine), so most patients feel little to no pain at the time. Afterwards, some soreness around the treated area is normal for a few days, and most people find their back pain eases noticeably within the first week.
How soon will I feel relief after vertebroplasty or kyphoplasty?
Many patients notice a reduction in pain within one to three days after the procedure, though the full benefit can take a couple of weeks to settle in. Results vary depending on how old the fracture is, your general bone health, and whether more than one vertebra was treated.
How much does vertebroplasty or kyphoplasty cost?
The cost depends on several factors specific to your case, including whether you need vertebroplasty or kyphoplasty (kyphoplasty uses an inflatable balloon device that adds to the cost), how many vertebrae are being treated, the class of hospital you choose, and the length of your stay. A written cost estimate from the hospital is the most reliable way to get a real figure for your situation.
This page is general information, not a substitute for medical advice. Every case is different. Your doctor decides what is right for you.
