Meet Dr. Inouye, Tucson physician
Dr. Lindsey Inouye is one of our experts on Kyphoplasty in Tucson, a treatment for vertebral compression fractures. Our fellowship-trained Interventional Radiologists have special training in interventional and vascular procedures, allowing them to successfully diagnose and treat patients with a wide variety of challenging medical conditions.
Kyphoplasty is an image-guided procedure used to treat painful vertebral compression fractures in the thoracic and lumbar spine. Vertebral compression fractures may be due to a number of causes, including trauma or tumor, but are most commonly secondary to osteoporosis.
The diagnosis of a vertebral compression fracture is frequently made on X-ray studies of the spine. Most patients then undergo an MRI scan to determine the age of the fracture and if there are any other sources of pain. People who cannot have an MRI scan may undergo a CT scan and bone scan to determine the age of the fracture.
In kyphoplasty, a hollow needle called a trocar is inserted through a small hole in the skin and is then advanced into the fractured vertebral body. A balloon is inserted into the vertebral body and then inflated to create a cavity. The balloon is then removed, and bone cement is injected into the cavity, which stabilizes the fracture and allows it to heal. The use of a balloon differentiates kyphoplasty from vertebroplasty and may better restore the height of the affected vertebral body.
You will be asked not to eat after midnight the night before the procedure. You may have clear liquids up to 2 hours before the procedure but should eat nothing after that.
If you are taking prescribed anticoagulants (blood thinners) such as Coumadin or Plavix, you should ask your physician for instructions prior to the procedure. Patients should not take over-the-counter aspirin or aspirin-containing medications for at least 5 days prior to their procedure. Please consult with your doctor or healthcare provider before stopping ANY medications.
Please arrive for your procedure with a responsible adult who can drive you home.
Prior to your procedure, you will have a thorough consultation with our Interventional Radiology nurse practitioner and one of our Interventional Radiologists. All possible treatment options will be reviewed and discussed with you in detail, and all of your questions will be answered.
After you arrive for your appointment, you will be escorted to a procedure room, where you will be asked to change into a patient gown. You will have an intravenous (IV) line placed in your arm so that pain medication and sedatives can be administered prior to and during your procedure. You will be positioned on an exam table, and fluoroscopy will be used to determine the most appropriate needle entry site. The radiologist will cleanse the overlying skin, and a small amount of local anesthetic (lidocaine) will be injected with a small needle. You will feel a tiny pinch similar to a pinprick while the anesthetic is injected.
After the area becomes numb, the radiologist will make a small nick in the skin and will insert the trocar into the fractured vertebral body while observing under fluoroscopy. A small amount of contrast material may be injected to confirm the proper needle position. The balloon will then be inserted through the needle and will be inflated to create a cavity in the fractured vertebra, and bone cement mixed with a small amount of inert barium will be injected through the needle into the cavity created by the balloon. Once a sufficient amount of bone cement has been placed, the needle will be removed, and a bandage will then be placed over the insertion site. You will remain on your stomach for about ten minutes while the cement begins to harden. You will then turn over and lie on your back for up to two hours while the cement continues to strengthen. You will be then discharged and will be given instructions and phone numbers of whom to call if you have any problems.
The contrast agent that is used during the procedure is an iodine-based material. Radiology Ltd. uses only non-ionic contrast agents (the safest kind), but with all contrast agents there is always the potential for allergic reaction. Be sure to tell your technologist if you have experienced a reaction to CT contrast in the past. If you are diabetic and take Glucophage, Glucovance, or any other type of metformin medication to regulate your diabetes, you will need to stop taking it for 48 hours after your exam.
For your safety and the protection of others, we do not allow anybody except patients in our exam rooms.
Significant complications related to kyphoplasty are very uncommon. The primary risks associated with this procedure include:
- Allergic reaction to the contrast material
- Cement leakage affecting adjacent neural structures
Most kyphoplasty procedures are very well tolerated. You may apply ice to the needle insertion site to reduce swelling if necessary. Symptoms usually disappear within 48 hours; contact your physician or healthcare provider if they persist for more than two days.