I had a balloon kyphoplasty that seemed to work at first but then later, the spine collapsed again. Was there anything that could have been done differently to make this work better?

Balloon kyphoplasty has been used to restore height and function of the vertebral bone after compression fracture. Once the bone collapses, pain and deformity reduce function and quality of life.

The advantages of this minimally invasive approach are: 1) rapid pain reduction, 2) fast recovery and return to daily activities, and 3) few risks or problems after the procedure.

Improvements in the kind of cement used seem to have produced even better results. Calcium phosphate bone cement is being used more often and replacing polymethylmethacrylate (PMMA).

The self-hardening calcium phosphate bone cements are biocompatible. They do not heat up or create toxic effects on the bone. They can even stimulate new bone to grow, a process called osteoconductivity.

Researchers are experimenting with the use of cement along with reinforcement of the segment with screws and/or bone graft material. The hope is to prevent vertebral collapse and loss of correction.

Studies show that collapse is more likely without support along the front of the spine. Disc material migrates or moves from between the two vertebrae through the endplate into the fractured vertebral body. That’s why kyphoplasty has become more popular — it reinforces the bone and reduces the risk of failure, especially in osteoporotic bone.

Today, a combination of kyphoplasty and screw fixation to hold everything in place may prevent problems such as you had. More study is needed to find out what are the long-term results.