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Mother had a balloon kyphoplasty for fractures in her lumbar spine about six months ago. That worked great but now she has two more (new) fractures. Can she have this same surgery again? How do we know for sure the new fractures weren't caused by the stiff bones from the kyphoplasty?

These are two very good questions. Based on studies of results from balloon kyphoplasty, it looks like the procedure can be repeated. Results are not compromised by having had a previous kyphoplasty. Many vertebral compression fractures (VCFs) that occur later (after the first kyphoplasty procedure) affect the adjacent (next) vertebra -- but just as many are at a distance from the original fractures. It does not appear that the increased bone height or stiffness from the kyphoplasty procedure is linked with further fractures. It is more likely that the underlying cause (osteoporosis or "brittle bone") is the problem. Spine bones weakened from osteoporosis (brittle bones) may become unable to support normal stress and pressure. As a result, something as simple as coughing, twisting, or lifting can cause a vertebra to fracture. In fact, a simple action like reaching down to pull on a pair of socks can cause a weakened vertebra to crack or fracture. The front of the vertebra (the part closest to the front of the body) crumbles, causing the round vertebral body to become wedge-shaped. This angles the spine forward, producing a hunch-backed appearance, called kyphosis. That's where a balloon kyphoplasty comes in. The procedure restores the height of the vertebral body and corrects the kyphosis deformity. Balloon kyphoplasty is considered both safe and effective -- and not the cause of further problems.

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