Percutaneous Procedures

What are Percutaneous Spine Procedures?

Percutaneous spine procedures are minimally invasive treatments performed through small skin incisions or needle punctures to stabilise the spine, relieve pain, and treat selected vertebral fractures or spinal instability.

Unlike traditional open surgery, these procedures use image guidance, specialised needles, guidewires, screws, bone cement, balloons, and other instruments to reach the affected vertebrae while limiting damage to surrounding muscles and soft tissues.

Common percutaneous spine procedures include:

• Percutaneous spinal fixation
• Vertebroplasty
• Kyphoplasty

Percutaneous spinal fixation uses screws and rods inserted through small incisions to stabilise unstable vertebrae. Vertebroplasty involves injecting medical-grade bone cement into a fractured vertebra. Kyphoplasty is similar but uses a balloon to create a cavity and, in selected cases, improve vertebral height before cement is introduced.

Dr. Yadhu K Lokanath, Consultant Neurosurgeon and Spine Surgeon in Bangalore, carefully reviews each patient’s symptoms, imaging, bone quality, neurological condition, and overall health before recommending a percutaneous procedure.

What Conditions Can These Procedures Treat?

Percutaneous spine procedures may be considered for:

• Osteoporotic vertebral compression fractures
• Painful spinal fractures
• Traumatic vertebral fractures
• Selected spinal tumours
• Vertebral collapse due to cancer
• Spinal instability
• Selected spinal infections after appropriate treatment
• Spondylolisthesis
• Degenerative spinal conditions requiring fixation
• Instability following spinal decompression
• Multiple vertebral fractures
• Patients who may benefit from a less invasive surgical approach

The most appropriate procedure depends on whether the primary problem is pain from a fractured vertebra, loss of vertebral height, spinal instability, deformity, or neurological compression.

What is the Anatomy Involved?

These procedures involve structures such as:

• Vertebral bodies
• Pedicles
• Intervertebral discs
• Spinal canal
• Spinal cord
• Nerve roots
• Posterior spinal elements
• Paraspinal muscles
• Bone cement
• Pedicle screws and rods

The vertebral body supports much of the spine’s weight. When it weakens or collapses, it may cause severe pain, reduced mobility, progressive deformity, or instability.

What are the Symptoms?

Patients who may require evaluation can experience:

• Sudden or persistent back pain
• Pain that worsens while standing or walking
• Pain following a fall or minor injury
• Difficulty turning in bed
• Reduced height
• Stooped posture
• Local tenderness over the spine
• Difficulty walking
• Reduced ability to perform daily activities
• Pain caused by spinal movement
• Progressive spinal deformity

If a fracture or instability compresses the nerves, symptoms may also include numbness, tingling, weakness, or radiating pain.

When Should I See a Spine Surgeon?

Consult a spine surgeon if severe back pain begins after a fall, injury, or minor strain, particularly in patients with osteoporosis, cancer, or long-term steroid use.

Seek urgent medical attention if symptoms include:

• Progressive arm or leg weakness
• Loss of bladder or bowel control
• Numbness around the genital region
• Difficulty walking
• Severe pain after significant trauma
• Fever with spinal pain
• A history of cancer with new back pain
• Sudden spinal deformity

These symptoms may indicate neurological compression, infection, tumour involvement, or an unstable fracture.

How is the Condition Diagnosed?

Evaluation may include:

• Detailed medical history
• Physical examination
• Neurological examination
• X-rays of the spine
• MRI
• CT scan
• Bone-density testing
• Whole-spine standing X-rays
• Blood tests
• Cancer-related investigations when required
• Biopsy in selected suspicious vertebral lesions

MRI can help determine whether a fracture is recent and identify spinal-canal involvement, nerve compression, infection, or tumour.

Can It Be Managed Without Surgery?

Some stable compression fractures may initially be managed with:

• Short-term activity modification
• Pain medication
• Osteoporosis treatment
• Calcium and vitamin D when prescribed
• Temporary spinal bracing
• Physiotherapy
• Fall-prevention measures
• Gradual mobilisation
• Treatment of the underlying cancer or bone disorder

Prolonged bed rest is generally avoided because it may contribute to muscle loss, blood clots, lung complications, and further bone weakness.

When are Percutaneous Procedures Recommended?

A percutaneous procedure may be considered when:

• Severe fracture pain persists despite conservative treatment
• Pain prevents walking or rehabilitation
• The vertebral fracture is recent and active
• Spinal instability is present
• A tumour has weakened the vertebral body
• Minimally invasive stabilisation is appropriate
• Open surgery carries increased risk
• Internal fixation is needed after decompression
• Vertebral collapse is progressing

Not every compression fracture requires cement augmentation. Clinical symptoms and imaging findings must match before treatment is recommended.

Percutaneous Spinal Fixation

Percutaneous spinal fixation stabilises the spine using screws inserted through small incisions into the vertebral pedicles. Rods are passed beneath the skin and connected to the screws.

The procedure may be combined with decompression, fusion, fracture reduction, or vertebral augmentation. It is commonly used for selected fractures, degenerative instability, tumours, and minimally invasive spinal fusion.

Potential advantages include:

• Smaller incisions
• Reduced muscle disruption
• Lower blood loss
• Less postoperative pain
• Earlier mobilisation
• Shorter hospital stay in selected patients

Vertebroplasty

Vertebroplasty involves inserting a needle into the fractured vertebral body under fluoroscopic or CT guidance. Medical-grade bone cement is slowly injected to stabilise the weakened bone.

The aim is primarily to reduce pain caused by movement within the fractured vertebra. Vertebroplasty does not reliably restore lost vertebral height.

Kyphoplasty

During kyphoplasty, one or more balloons are inserted into the fractured vertebra and gently inflated. This creates a cavity and may partially restore vertebral height in selected fractures.

The balloons are then removed, and bone cement is injected into the cavity. Kyphoplasty may help stabilise the fracture, reduce pain, and limit further collapse.

Recovery and Possible Risks

Many patients are encouraged to stand and walk within hours or by the following day. Hospital stay depends on the procedure, number of vertebrae treated, and the patient’s health.

Possible risks include:

• Infection
• Bleeding
• Nerve injury
• Cement leakage
• Cement entering a blood vessel
• Allergic reaction
• Persistent pain
• Implant loosening or malposition
• Fracture of an adjacent vertebra
• Spinal-fluid leakage
• Need for further surgery

Careful imaging guidance and appropriate patient selection help reduce these risks.

Why Choose Dr. Yadhu K Lokanath?

Dr. Yadhu K Lokanath offers:

• Detailed neurological and spinal evaluation
• Fellowship training in minimally invasive and endoscopic spine surgery
• Expertise in spinal fractures and instability
• Image-guided procedural planning
• Personalised treatment selection
• Modern percutaneous fixation techniques
• Osteoporosis and rehabilitation guidance
• Comprehensive postoperative follow-up

Frequently Asked Questions

Are these procedures major surgeries?

They are spine procedures, but they are performed through small incisions or needle punctures and usually involve less tissue disruption than open surgery.

Is vertebroplasty the same as kyphoplasty?

No. Vertebroplasty involves direct cement injection, while kyphoplasty uses a balloon before the cement is inserted.

Will kyphoplasty restore my full height?

It may partially improve vertebral height in selected recent fractures, but complete restoration is not guaranteed.

How quickly can pain improve?

Some patients experience early improvement, while others improve gradually over several days.

Is bone cement permanent?

Yes. The cement remains inside the treated vertebra to provide long-term internal support.

Will I still need osteoporosis treatment?

Yes. Treating osteoporosis remains essential to reduce the risk of future fractures.

Book an Appointment

Persistent pain from a vertebral fracture, spinal instability, or vertebral collapse can severely limit mobility and independence. Percutaneous spinal fixation, vertebroplasty, or kyphoplasty may offer stabilisation and pain relief with limited tissue disruption in appropriately selected patients.

Consult Dr. Yadhu K Lokanath, Consultant Neurosurgeon and Spine Surgeon in Bangalore, for expert evaluation and a personalised percutaneous spine treatment plan.