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Interventional spine · London

Kyphoplasty and vertebroplasty, by a specialist interventional team.

A day-case cement augmentation for painful acute vertebral compression fractures, done by an interventional radiologist or spine surgeon with a high caseload, in a fluoroscopy-equipped theatre, with on-site spine surgery cover if it is ever needed.

A stethoscope on a clinical desk

Indicative pricing

What private vertebral augmentation costs in London.

Indicative ranges across UK units.

In short

£10,000 to £15,000, home the same day.

Procedure Indicative range
Assessment, MRI STIR review and consent £450 to £850
Single-level vertebroplasty £8,500 to £13,500
Single-level balloon kyphoplasty £10,000 to £15,000
Two-level balloon kyphoplasty £12,500 to £18,500
SpineJack (titanium implant) augmentation £14,000 to £22,000
Second-opinion review of MRI and pain history £250 to £450

Prices vary by unit, by operator, by whether balloon, SpineJack or vertebral stent hardware is used, and by anaesthetic.

The journey

From MRI to medical therapy - what happens, in order.

One team from first message to follow-up - including the bone-protection medication that stops the next fracture.

  1. 04

    On the day

    Arrival at the unit

    Arrival, consent and a chat with the operator and anaesthetist. Local anaesthetic with sedation for most, general anaesthetic for multi-level or anxious cases.

  2. 05

    On the day

    The augmentation itself

    30 to 45 minutes per level, prone on the table. Transpedicular needles under fluoroscopy, balloon inflated to create a cavity, then PMMA cement injected slowly under live imaging.

  3. 06

    On the day

    Home the same day

    One to two hours flat-lying recovery, mobilisation with physio, written aftercare, and home within a few hours. Most patients report pain relief within 24 to 72 hours.

  4. 07

    After

    Medical therapy and follow-up

    Zoledronate, denosumab or romosozumab started, vitamin D and calcium topped up, falls advice, and a review at 6 weeks with repeat imaging if needed.

When it helps

When cement augmentation is the right step - and when it is not.

The fracture patterns treated most often, and the imaging findings that mean cement is not appropriate.

  • Acute osteoporotic vertebral compression fracture

    A painful wedge fracture within 4 to 6 weeks, confirmed by MRI STIR-positive marrow oedema, and not settling on optimised analgesia.

  • Painful metastatic or myeloma vertebral fracture

    Pathological collapse from breast, prostate, lung or myeloma disease, where cement augmentation gives structural support and rapid pain relief.

  • Selected traumatic burst fracture

    Stable, neurologically intact burst fractures without significant canal compromise, in patients otherwise unfit for open surgery.

  • Failure of conservative treatment

    Severe pain persisting beyond 3 to 4 weeks of bed rest, analgesia and bracing, with ongoing marrow oedema on MRI.

  • Multi-level osteoporotic collapse

    Multiple painful wedge fractures in advanced osteoporosis, augmented in one or two sittings alongside bone-strengthening medical therapy.

  • Kummel disease (avascular necrosis)

    Delayed post-traumatic vertebral collapse with intravertebral cleft, where cement fills the cavity and restores support.

  • Old healed fracture

    A wedge deformity on X-ray with a negative MRI STIR is a healed fracture. It does not benefit from cement.

  • Red flag: neurology, infection or instability

    New leg weakness, sphincter change, sepsis or a three-column injury needs urgent spinal surgery review, not vertebroplasty.

Procedure options

Vertebral augmentation is a family of techniques.

What each option on the table actually involves, and which fits which fracture. Not every fracture needs the most expensive implant.

  • Vertebroplasty

    Direct percutaneous injection of PMMA bone cement into the fractured vertebral body under fluoroscopy. Quick, effective for pain, but no height restoration.

  • Balloon kyphoplasty

    An inflatable balloon is passed first to create a cavity and restore 3 to 8 mm of vertebral height, then cement is injected into the low-pressure cavity.

  • SpineJack (Stryker)

    A titanium expandable implant is deployed inside the vertebral body to restore height mechanically, then locked in place with a small volume of cement.

  • Kiva (Benvenue)

    A coiled PEEK implant creates a contained nest for the cement, reducing extravasation risk in cortically deficient vertebrae.

  • Vertebral body stenting

    An expandable metal stent holds the restored cavity open while cement is injected, giving more predictable height correction than a balloon alone.

  • Bilateral vs unilateral approach

    Bilateral transpedicular access gives symmetrical cement fill; a unilateral approach shortens the procedure and radiation dose when the fracture morphology allows.

  • Sedation vs general anaesthetic

    Most single-level cases are done under local anaesthetic with light sedation, prone. Multi-level, anxious or metastatic cases are often done under GA.

  • Second-opinion review

    A specialist review of your MRI, X-rays and analgesia history, in case the honest answer is medical therapy, a brace and time rather than a needle.

Safety and recovery

What to expect afterwards - honestly.

A well-established interventional procedure. The things worth planning are cement leak monitoring, adjacent-level risk, and starting bone-strengthening medication.

  • Cement extravasation, mostly silent

    Cement leak on imaging happens in 5 to 30% of cases, but symptomatic leaks are only 1 to 2%. Live fluoroscopy monitoring is what keeps this low.

  • Pulmonary cement embolism

    Small cement fragments can reach the lungs in under 1% of cases. Almost all are asymptomatic and picked up incidentally on later imaging.

  • Adjacent-level fracture

    A neighbouring vertebra can fracture within 12 months in around 10 to 20% of osteoporotic patients. Bone-strengthening medical therapy is essential, not optional.

  • Canal or foraminal cement, needing surgery

    Symptomatic epidural or foraminal cement extravasation requiring decompression is under 1% in specialist hands. On-site spine surgery cover matters.

  • Infection and nerve injury

    Spondylodiscitis and needle-tract nerve irritation are each under 1%. Sterile technique, antibiotic prophylaxis and careful pedicle targeting keep the risk low.

  • What the pain relief looks like

    60 to 80% of patients report substantial pain reduction within 24 to 72 hours, with opioid weaning starting in the first week. It is not universal.

  • Bracing and mobilisation

    A short course of thoracolumbar bracing and physiotherapy-led mobilisation for 4 to 6 weeks helps protect neighbouring levels while medical therapy takes effect.

  • Falls, DEXA and vitamin D

    A DEXA scan, vitamin D 800 IU and calcium 1000 mg daily, and a falls-prevention review are as important as the cement itself.

  • Red flags after discharge

    New leg weakness, numbness, sphincter change, fever, chest pain or breathlessness needs same-day A&E review, not a wait-and-see call.

Reading your procedure report

Your augmentation report in four parts. Read the last one first.

Whichever hardware was used, the report the operator sends you keeps to the same shape.

  1. 01 Header

    Level, approach and cement volume

    Which vertebrae were treated, unilateral or bilateral access, needle gauge, cement type and total volume injected per level.

  2. 02 Technique

    Balloon, stent or direct injection

    Whether a balloon, SpineJack, Kiva or vertebral stent was used, the height restoration achieved, and any anatomical difficulty encountered.

  3. 03 Findings

    Extravasation and complications

    Any cement leak seen on fluoroscopy or post-procedure CT, its location (disc, paravertebral, venous, epidural), and whether it was symptomatic.

  4. 04 Impression

    Medical therapy and follow-up plan

    Read this first: which bone-protection drug is being started, DEXA plan, brace advice, and the interval for clinical review and repeat imaging.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Cover for kyphoplasty and vertebroplasty varies by insurer and by indication, usually funded when medically indicated.

Frequently asked

Common questions about vertebral augmentation.

Quick answers on evidence, recovery, cost and the bone-protection medication you will need afterwards.

  • What is the difference between vertebroplasty and kyphoplasty?

    Vertebroplasty is a direct percutaneous injection of PMMA bone cement into a fractured vertebral body under fluoroscopy. Kyphoplasty adds a step first: an inflatable balloon is passed through the pedicle and inflated to create a cavity and restore 3 to 8 mm of vertebral height, and cement is then injected into that low-pressure cavity. Both give similar pain relief; kyphoplasty gives better height correction and lower cement-leak rates.

  • Does the evidence actually support cement augmentation?

    Modern trials support it in the right window. VAPOUR and VERTOS IV showed kyphoplasty and vertebroplasty were superior to sham in acute (under 6 weeks), STIR-positive, severely painful osteoporotic fractures. NICE TA279 supports its use. Earlier INVEST and VERTOS I trials, which included older fractures and less severe pain, were negative. The consensus now is that patient selection, and doing it early, is what matters.

  • What is the recovery like and when will the pain settle?

    The procedure is a day case. You lie flat for 1 to 2 hours after cement injection to let it cure fully, then mobilise with physiotherapy. 60 to 80% of patients report substantial pain relief within 24 to 72 hours, and opioid weaning usually starts within the first week. A short course of bracing for 4 to 6 weeks helps protect neighbouring levels.

  • What are the real risks I need to know about?

    Cement extravasation on imaging happens in 5 to 30% of cases but is symptomatic in only 1 to 2%. Pulmonary cement embolism is under 1% and almost always asymptomatic. The most important longer-term risk is adjacent-level fracture, at 10 to 20% within a year, which is why starting a bisphosphonate, denosumab or romosozumab is essential. Symptomatic canal cement requiring surgery is under 1% in specialist hands.

  • How much does it cost privately in the UK?

    Single-level vertebroplasty runs £8,500 to £13,500 and single-level balloon kyphoplasty £10,000 to £15,000. Two-level kyphoplasty is £12,500 to £18,500. SpineJack titanium augmentation is £14,000 to £22,000. A second-opinion MRI and pain review is £250 to £450.

  • Do I still need osteoporosis medication if I have the cement?

    Absolutely. Cement fixes the current fracture but does nothing for the underlying bone disease. Zoledronate infusion once a year, alendronate weekly, denosumab 60 mg subcutaneous every 6 months, or romosozumab 210 mg monthly for 12 months, alongside vitamin D 800 IU, calcium 1000 mg, weight-bearing exercise and falls-prevention, is what stops the next vertebra collapsing.

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