Vertebroplasty or kyphoplasty
An image-guided procedure that injects special bone cement into a painful collapsed (fractured) spinal bone to stabilise it and help reduce pain, for selected people whose severe pain has not settled with other treatment.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- Cement is injected into a painful, recently fractured spinal bone through the skin under X-ray guidance to stabilise it and help reduce pain.
- NICE recommends it only for severe, ongoing pain from a recent unhealed fracture that has not settled despite proper pain management — not for every fracture.
- Evidence on how much better it is than a placebo procedure is mixed for some patients, so the likely benefit should be discussed honestly.
- It does not treat the underlying osteoporosis or cancer, and new fractures can still happen, so bone and disease treatment must continue.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your radiologist will give you advice for your situation.
Can reduce severe pain from a recent fracture, sometimes quite quickly
The fracture is old and healed, or the pain is not clearly coming from the fracture level.
You lie flat for a period while the cement sets fully and you are watched in recovery. Soreness at the needle site is normal.
A clear plan to treat the underlying osteoporosis or cancer and prevent further fractures.
You lie flat for a period while the cement sets fully and you are watched in recovery. Soreness at the needle site...
You gradually sit up and start moving, often going home the same day or after an overnight stay. Some people...
Take it easy and avoid heavy lifting, bending and twisting. Continue prescribed pain relief and gradually increase...
Activity is built up steadily, sometimes with physiotherapy. Your osteoporosis or cancer treatment continues to...
What are vertebroplasty and kyphoplasty?
Vertebroplasty and kyphoplasty are image-guided procedures that treat a painful collapsed spinal bone (a vertebral compression fracture). A specialist passes a needle through the skin of the back, under X-ray (sometimes with CT) guidance, into the fractured bone and injects special bone cement, which hardens to stabilise it. In kyphoplasty, a small balloon is first inflated inside the bone to make a space and partly restore its height before the cement is put in.
These fractures are most often caused by thinning of the bones (osteoporosis), and sometimes by cancer affecting the spine (such as secondary tumours or myeloma). The aim is to reduce pain and help you move more easily when a recent fracture is causing severe, ongoing pain that has not settled.
It is important to be realistic. NICE recommends these procedures only for people with severe ongoing pain from a recent, unhealed fracture, confirmed at that level, whose pain has not settled despite proper pain management — not for every spinal fracture. Many osteoporotic fractures improve with pain relief and time. The evidence on how much better cement is than a 'dummy' (placebo) procedure has been mixed for some patients, so it is worth discussing honestly. The procedure does not treat the underlying osteoporosis or cancer, which need their own treatment.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Vertebroplasty versus balloon kyphoplasty
| Feature | Vertebroplasty | Balloon kyphoplasty |
|---|---|---|
| Extra step | Cement injected directly | Balloon makes a cavity first |
| Aim on height | Stabilise; little height change | May partly restore lost height |
| Cement leak risk | Cement can leak out of the bone | May reduce, but not remove, leak risk |
| Main goal | Reduce pain, stabilise fracture | Reduce pain, stabilise, address shape |
Your specialist will advise which, if either, suits your fracture. Both aim mainly at pain and stability, not at straightening the spine.
Preparing for your procedure
- Bring recent scans (X-ray, MRI or CT) — these confirm the fracture is recent and is the source of your pain.
- Discuss honestly how severe your pain is, what you have already tried, and how long the fracture has been there.
- Tell the team about allergies, infections, and any cancer or bone condition affecting your spine.
- Tell them about blood-thinning medicines (such as warfarin, apixaban or clopidogrel), which usually need managing first.
- You may be asked not to eat for several hours if sedation or general anaesthetic is planned, and to arrange someone to take you home.
- Let them know if you might be pregnant, as X-ray and CT use radiation.
- Make sure your osteoporosis or cancer treatment plan is in place, as the procedure treats the fracture, not the cause.
What happens
You usually lie face down on an X-ray table and are connected to monitors. You are given local anaesthetic to the skin and deeper tissues, often with sedation to keep you comfortable; sometimes a general anaesthetic is used. Antibiotics may be given through a vein to lower the chance of infection.
Using live X-ray pictures (sometimes with CT), the specialist guides a hollow needle through a small puncture in your back into the fractured vertebra. In kyphoplasty, a balloon is inflated inside the bone first to create a cavity. Special bone cement is then injected and allowed to harden, which usually takes about 10 to 20 minutes. The position of the cement is watched carefully throughout.
The needle is removed and a small dressing applied — there is no large cut. The procedure usually takes around 45 to 90 minutes depending on how many bones are treated. Afterwards you lie flat for a period and are watched in recovery before gradually sitting up and moving, often on the same day.
Is this procedure right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- The fracture is old and healed, or the pain is not clearly coming from the fracture level.
- Pain is mild or moderate, or has not yet been treated with proper pain management.
- There is infection near the spine or in the bloodstream.
- A bleeding tendency or blood-thinning medicine cannot be safely managed.
- There is significant compression of the spinal cord or nerves that needs different treatment.
Delay or rearrange if…
- Optimal pain management with medicines and time has not yet been tried for a recent fracture.
- You have an active infection or unexplained fever.
- Blood-thinning medicines have not been managed as advised.
- The cause of the fracture (osteoporosis or cancer) has not yet been assessed and a treatment plan started.
- There is a chance you are pregnant and the procedure uses X-ray or CT.
Alternatives to discuss
- Pain relief, gentle activity and time, which settle many osteoporotic fractures.
- A back brace or support in selected cases.
- Physiotherapy and falls prevention.
- For cancer-related fractures, radiotherapy or other cancer treatments, and surgery in some cases.
- Treating the underlying osteoporosis with bone-protection medicines.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Comfort, sedation or contrast choices
If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.
Benefits
- Can reduce severe pain from a recent fracture, sometimes quite quickly
- Can make it easier to move, stand and reduce time in bed
- May lower the amount of strong pain medicine needed
- Stabilises the fractured bone; kyphoplasty may partly restore its height
- Done through a needle puncture rather than open surgery, so recovery from the procedure is usually short
Risks & complications
- Soreness or bruising at the needle site in the back
- A short-lived increase in pain for a day or two
- Some cement leaking outside the bone (often causes no symptoms but is watched for)
- Temporary tiredness or grogginess if sedation was used
- Cement leak that presses on a nerve, causing new pain, numbness or weakness
- A new fracture in a nearby vertebra over the following months
- Infection at the site or, rarely, in the bone
- Bleeding or bruising in the surrounding tissues
- Cement entering a vein and travelling to the lungs, which can be serious
- Direct injury to the spinal cord or nerves, which can cause weakness or, very rarely, paralysis
- A serious allergic or other reaction during the procedure
- A leak requiring an urgent operation to relieve pressure on the spinal cord
The most important specific risks are cement leaking outside the bone (common, but usually harmless) and, rarely, cement pressing on nerves or travelling to the lungs. New fractures in nearby bones can also happen, partly because the underlying osteoporosis or cancer remains. Because of this, the procedure should be done by an experienced team and combined with proper treatment of your bones or cancer. Ask your specialist how likely the procedure is to help you specifically, given the mixed evidence in some patients.
Published figures to discuss
How much a person benefits varies, and trials comparing cement with a placebo procedure have given mixed results for some patients, particularly in osteoporotic fractures. Cement leaks are common but usually cause no symptoms; serious complications are uncommon. The ranges below are drawn from UK and European patient information for general guidance and should be discussed in the context of your own fracture and health.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Cement leaking outside the treated bone | Reported in roughly 5–10 in 100 procedures in patient information | Usually causes no symptoms, but is watched for because it can rarely press on nerves or reach a vein. | NICE TA279 — Vertebroplasty and kyphoplasty for osteoporotic vertebral compression fracturesnice.org.ukSource-linked context |
| A new fracture in a nearby vertebra | Reported around 8–10 in 100 over the following months in patient information | Reflects the ongoing osteoporosis or cancer; treating the cause helps reduce this. | Guide sourcesClinical context |
| No meaningful pain relief | A minority; benefit is most likely when pain clearly comes from a recent fracture | MRI evidence of an active fracture and matching focal pain are important selection factors. | Guide sourcesClinical context |
| Serious nerve compression or cement embolus | Rare | New leg weakness, numbness, bladder or bowel symptoms, chest pain or breathlessness needs urgent assessment. | NICE TA279 — Vertebroplasty and kyphoplasty for osteoporotic vertebral compression fracturesnice.org.ukSource-linked context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
Recovery from the procedure itself is usually short. You will rest flat for a while, then gradually sit and move. Any pain relief from the cement may begin within a day or two, but this varies and is not guaranteed.
- Soreness or bruising at the needle site for a few days
- A short-lived flare of pain before any improvement
- Gradual rather than instant change in pain for many people
- Tiredness for a day or so, especially if sedation or anaesthetic was used
Aftercare
- Rest and avoid heavy lifting, bending and twisting in the first days as advised.
- Take prescribed pain relief and reduce it gradually as pain allows.
- Keep the small dressing clean and dry for the first day.
- Build up gentle activity steadily, and follow any physiotherapy advice.
- Keep taking your osteoporosis or cancer treatment as prescribed.
- Stay well hydrated and move regularly to reduce stiffness.
- Know the warning signs below and who to contact urgently.
- Someone to take you home and help for the first day or two
- Prescribed pain relief at home
- A clear plan for your osteoporosis or cancer treatment
- Physiotherapy or activity advice for the first weeks
- A review appointment to check pain and function
- Knowing the urgent warning signs and who to contact
Scars and how they heal
There is no surgical scar. The cement is injected through one or two small needle punctures in the back, which leave tiny marks that may bruise and usually fade within days.
⚠ Get urgent help if…
- New or worsening weakness or numbness in the legs
- Loss of control of your bladder or bowels — call 999
- Sudden severe back pain different from before (possible new fracture)
- Sudden breathlessness or chest pain — call 999
- Fever, increasing back pain, or redness and discharge at the needle site (possible infection)
- Severe or spreading pain that pain relief does not control
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your radiologist gives you.
Results & realistic expectations
A good result is a meaningful reduction in pain from a recent fracture, so you can move more easily and rely less on strong painkillers. For some people relief begins within a day or two; for others it is more gradual or more limited. The evidence on how much better cement is than a placebo procedure has been mixed for some patients, so it is important not to expect a guaranteed cure. The procedure stabilises one fractured bone — it does not treat the osteoporosis or cancer behind it, which still need their own treatment.
When the procedure helps, the cement permanently hardens the treated bone and the pain relief can last. However, because the underlying osteoporosis or cancer remains, new fractures can occur in other bones over time. Continuing bone-protection medicine or cancer treatment, and reducing fall risk, are key to lasting benefit. Some people need more than one bone treated, either at the same time or later.
Related tests, treatments or support
Vertebroplasty or kyphoplasty is one part of managing spinal fractures. It is normally combined with treatment of the cause — osteoporosis medicines and bone health measures, or cancer treatment such as radiotherapy or systemic therapy. Physiotherapy and falls prevention also matter. The procedure should never replace treating the underlying condition.
Follow-up & long-term care
You will usually be reviewed to check your pain and movement and to make sure your bone-protection or cancer treatment is in place. Any new back pain should be reported, as it may indicate a new fracture that needs assessment. Seek urgent help for leg weakness, bladder or bowel problems, breathlessness or signs of infection rather than waiting for review.
- Ongoing osteoporosis treatment and bone-health measures (such as vitamin D, calcium and prescribed medicines) where relevant
- Continued cancer treatment and surveillance where the fracture is cancer-related
- Falls prevention and safe, regular activity
- Prompt assessment of any new back pain in case of a further fracture
Repeat, follow-on and what comes next
- More than one bone may need treating, at the same time or later.
- A new fracture in another bone may lead to a further procedure.
- If a cement leak presses on nerves, an urgent operation may rarely be needed.
- The procedure does not stop the underlying disease, so ongoing treatment is essential.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- A clear plan to treat the underlying osteoporosis or cancer and prevent further fractures.
- Review of pain and function, with physiotherapy and falls prevention as needed.
- Written urgent warning signs (leg weakness, bladder or bowel problems, breathlessness, infection) and who to contact.
- Prompt assessment of any new back pain in case of a further fracture.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Whether vertebroplasty or balloon kyphoplasty is done, and how many bones are treated
- The specialist's fee and use of an imaging room (X-ray, sometimes CT)
- The type of anaesthetic or sedation and its monitoring
- Devices and cement used
- Length of stay (day case or overnight)
- Follow-up review and ongoing treatment of the underlying condition
- The specialist and facility fees for the procedure
- Devices, cement and imaging guidance used
- The anaesthetic or sedation and its monitoring
- Whether one or more bones are included
- Follow-up review and how the result will be assessed
- What happens, and any cost, if a complication occurs or further treatment is needed
On the NHS? Vertebroplasty and kyphoplasty are available on the NHS for selected people with severe, ongoing pain from a recent unhealed fracture when other pain management has not worked; private access is mainly for speed or choice.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Presenting the procedure as a certain cure when the evidence is mixed for some patients.
- Not confirming the fracture is recent and the source of pain before proceeding.
- No plan to treat the underlying osteoporosis or cancer.
- Not explaining cement leak, new-fracture risk, or rare serious complications.
- No clear urgent warning signs for nerve problems or breathlessness afterwards.
Marketing red flags
- Claiming it 'straightens the spine' or guarantees pain relief.
- Offering it for old, healed or non-painful fractures.
- Recommending it before proper pain management has been tried for a recent fracture.
- Not mentioning the mixed evidence, or the need to treat the underlying condition.
Choosing a specialist safely
- Check the radiologist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the radiologist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good radiologist will welcome every one of these.
- Has my fracture been confirmed as recent and as the source of my pain?
- Given the mixed evidence, how likely is this to help me specifically?
- Would vertebroplasty or kyphoplasty be better for my fracture, or neither?
- What is being done to treat the cause — my osteoporosis or cancer — and prevent new fractures?
- What are the chances of cement leak or a new fracture in my case?
- What are the urgent warning signs afterwards, and who do I contact?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the radiologist who carries out my procedure, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this procedure not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Will this cure my back pain?
Who is this procedure suitable for?
Is it a big operation?
What is the difference between vertebroplasty and kyphoplasty?
Could I get another fracture afterwards?
How soon might my pain improve?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NICE TA279 — Vertebroplasty and kyphoplasty for osteoporotic vertebral compression fractures NICE TA279 — Recommendations BSIR — Vertebroplasty (patient information) CIRSE — Vertebral augmentation (patient information) CIRSE — Vertebral fractures
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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