A Non-Surgical Treatment for the Pain of Spine Fractures Caused by Osteoporosis

For women who have already experienced spinal fractures or who suffer from osteoporosis, there have been few effective treatments available until recently. Now, there are two safe, non-surgical, interventional radiology treatments offered at Bryn Mawr Hospital for those suffering from the pain of recent vertebral fractures.

Vertebroplasty is an outpatient procedure using X-ray imaging and conscious sedation. The interventional radiologist inserts a needle through a nick in the skin of the back, directing it under fluoroscopy (continuous, moving X-ray imaging) into the fractured vertebra. The physician than injects the medical-grade bone cement into the vertebra to stabilize it and prevent further collapse.

In addition to vertebroplasty, our Interventional Radiologists also perform percutaneous kyphoplasty, a slightly more involved technique for treating painful compression fractures of the spine. Your Interventional Radiologist may recommend kyphoplasty rather than vertebroplasty for treatment of your recent compression fracture as kyphoplasty has been shown to restore some height to the vertebra involved and may allow the bone cement to be delivered with greater precision.

What Causes Spine Fractures
Vertebral or spinal bone fractures typically occur in women over the age of 60. However, they are also common among younger people whose bones have become fragile due to the long term use of steroids or other drugs to treat diseases such as lupus, asthma and rheumatoid arthritis. In older adults, osteoporosis, a progressive weakening of the bone, is the primary cause of spinal fractures. For many people with osteoporosis, a spinal fracture means severely limited activity, constant pain and a serious reduction in the quality of their lives.

For women who have already experienced spinal fractures there have been few effective treatments available until recently. Now, a safe, non-surgical, interventional radiology treatment called vertebroplasty offers hope for those suffering from the pain of vertebral fractures.

Vertebroplasty is an outpatient procedure using X-ray imaging and conscious sedation. The interventional radiologist inserts a needle about the width of a small straw through a nick in the skin of the back, directing it under fluoroscopy (continuous moving X-ray imaging) into the fractured vertebra. The physician than injects the medical-grade bone cement into the vertebra. The cement hardens, stabilizes the bone and prevents further collapse. This stops the pain caused by bone rubbing against bone.

Diagnosis
Osteoporosis is called a "silent disease," because bone loss occurs without symptoms. People may not know they have osteoporosis until their bones become so weak that a simple strain, twist of the body, bump or fall causes a bone fracture. These fractures may occur almost anywhere, but the most common site of fracture is in the vertebrae, the bones that make up the spinal column.

These spinal fractures, also called compression fractures, are caused when the weakened vertebrae of the spine collapse - usually in the middle (thoracic) or lower (lumbar) spine. Initially, the fracture may feel like severe back pain. However, when more than one vertebra collapses, loss of height or spinal deformities such as kyphosis or "widow's hump" may result. For some individuals, the fracture stabilizes itself, and the pain goes away. But for many, the pain persists because the crushed bone continues to move and break.

Risk Factors for Osteoporosis
Factors that increase the likelihood of developing osteoporosis include:

• Being female
• Advanced age
• A family history of osteoporosis
• Post-menopausal or an abnormal absence of menstrual periods
• Anorexia or bulimia
• A diet low in calcium
• Long-term use of corticosteroids or anticonvulsants
• Lack of exercise
• Smoking
• Excessive use of alcohol

Benefits of Vertebroplasty
Because vertebroplasty is a minimally invasive procedure:

• No hospitalization or general anesthesia is required
• No surgical incision is needed - just a small nick in the skin
• No stitches are required

Most patients report that their pain is gone or significantly better within 48 hours and that they return to normal activity shortly after the procedure. Studies have shown that from 75 percent to 90 percent of people treated with vertebroplasty will have complete or significant reduction of their pain.

For more information or to schedule an appointment with a
Bryn Mawr Hospital interventional radiologist,
Call 1-866-CALL-MLH.