New Ways to Help People with Compression Fractures from OsteoporosisOsteoporosis, a problem of low bone density that commonly affects elderly women, seems to be getting a lot of press these days. Most of us know what osteoporosis is but aren't too familiar with what it does.
Osteoporosis is life changing. It results in pain and a host of health problems. Compression fractures happen when a spine vertebra, weakened and fragile from osteoporosis, collapses on itself from the weight of the body or from minor trauma. This leads to a loss of body height and causes the lungs and intestines to be compressed into a smaller space. Squished lungs don't work very well. And pressure on the stomach makes for a smaller appetite, resulting in poor nutrition. The pain from the fracture causes people to move less, so they end up loosing their muscle strength and their independence.
There is now a blend of news, both good and bad. The good news is that in the last few years, effective medication has become available to treat osteoporosis. However, it takes some time for the medicine to work, and it can't completely reverse the problem. Even when the spine bone heals, the fractured vertebra will not have regained its normal height.
Two minimally invasive procedures have been designed to address vertebral compression fractures: vertebroplasty and kyphoplasty. Both involve inserting a needle into the vertebra through the back of the spinal column. Doctors place the needle off to the side to avoid the spinal cord. Using an X-ray screen to see the area, the doctor places the needle into the spot where the fracture is located. In patients treated with vertebroplasty, the surgeon injects a special bone cement directly into the fracture. This procedure holds and strengthens the broken bone. However, it does not restore the normal height of the broken vertebra.
Kyphoplasty goes one step further. It involves placing a hollow tube into the broken vertebra. Then the doctor slides a deflated balloon through the tube. Inflating the balloon helps restore the original height of the broken vertebra. Bone cement is used to fill the space formed by the balloon. When the cement hardens, it fixes the bone in its newly repaired position. By regaining the original height of the vertebra, kyphoplasty helps eliminate pain and "unsquish" the internal organs.
A neurosurgeon usually performs the surgery. Both vertebroplasty and kyphoplasty are becoming readily available around the country. Done in the office or hospital, these procedures aren't without possible side effects. A small percentage of patients experiences side effects such as increased pain, cement leakage (in vertebroplasty, where the balloon isn't used), and pressure against the spinal cord. Fortunately, most patients (95 percent) have less pain right away. The need for narcotic pain medication is usually less after the surgery. And people treated by kyphoplasty have improved posture, mainly because the height of the fractured vertebra is regained and kyphosis (the hunched curve of the spine) is reduced.
Steven R. Garfin, MD, et al. New Technologies in Spine: Kyphoplasty and Vertebroplasty for the Treatment of Painful Osteoporotic Compression Fractures. In Spine. July 15, 2001. Vol. 26. No. 14. Pp. 1511-1515.
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