Editing Vertebral augmentation (section)

== Procedure ==
[[wikt:vertebropasty|Vertebroplasty]] and [[wikt:kyphoplasty|kyphoplasty]] are the two most common procedures for spinal augmentation. These [[medical terms]] are [[classical compound]]s of the suffix ''[[wikt:-plasty#English|-plasty]]'' meaning "molding or shaping surgically" (from [[Ancient Greek]] ''[[wikt:πλαστός|plastós]]'' "molded, formed") and the prefixes ''[[wikt:vertebro-#English|vertebro-]]'' "vertebra" (from [[Latin]] ''[[wikt: vertebra#Etymology 1|vertebra]]'' "joint, joint of the spine") and ''kypho-'' "humped; stooping forward" (from Ancient Greek ''[[wikt:κυφός#Ancient Greek|kyphos]]'' "crooked").<ref>''Oxford English Dictionary'' 2009.</ref>

=== Vertebroplasty ===
Vertebroplasty is typically performed by a spine surgeon or [[interventional radiologist]]. It is a minimally invasive procedure and patients usually go home the same or next day as the procedure. Patients are given local anesthesia and light sedation for the procedure, though it can be performed using only local anesthetic for patients with medical problems who cannot tolerate sedatives well.

During the procedure, bone cement is injected with a biopsy needle into the collapsed or fractured vertebra. The needle is placed with [[fluoroscopy|fluoroscopic x-ray]] guidance. The cement (most commonly [[poly methyl methacrylate]] (PMMA), although more modern cements are used as well) quickly hardens and forms a support structure within the vertebra that provide stabilization and strength. The needle makes a small puncture in the patient's skin that is easily covered with a small bandage after the procedure.<ref name="epainbook">Nicole Berardoni M.D, Paul Lynch M.D, and Tory McJunkin M.D. "Vertebroplasty and Kyphoplasty" 2008. Accessed 7 Aug 2009. http://www.arizonapain.com/Vertebroplasty-W.html</ref>

=== Kyphoplasty ===
[[File:VertcementX.png|thumb|Cement in a vertebra as seen on plain Xray.]]
Kyphoplasty is a variation of a vertebroplasty which attempts to restore the height and angle of [[kyphosis]] of a fractured [[vertebra]] (of certain types), followed by its stabilization using injected bone cement. The procedure typically includes the use of a small balloon that is inflated in the vertebral body to create a void within the cancellous bone prior to cement delivery.  Once the void is created, the procedure continues in a similar manner as a vertebroplasty, but the bone cement is typically delivered directly into the newly created void.<ref>{{Citation | last1 =Wardlaw | first1 =Douglas | last2 =Van Meirhaeghe | first2 =Jan | title =Balloon kyphoplasty in patients with osteoporotic vertebral compression fractures | journal = [[Expert Review of Medical Devices]] | volume =9 | issue =4 | pages =423–436 | date =2012 | language =en |pmid=22905846 | doi=10.1586/erd.12.27| s2cid =6448288 }}</ref>

In a 2011 review Medicare contractor NAS determined that there is no difference between vertebroplasty and kyphoplasty, stating, "No clear evidence demonstrates that one procedure is different from another in terms of short- or long-term efficacy, complications, mortality or any other parameter useful for differentiating coverage."<ref name="Noridian"/>