Fixing Painful Fractures of the Spine

A simple interventional radiology procedure called vertebroplasty is freeing people from the debilitating pain of spinal fractures caused by osteoporosis, restoring the quality of life they knew before the disease weakened their bones.

Often times, once a compression fracture of the spine occurs, a person’s overall health takes a downward spiral. These patients often find relief only by lying still in bed which can lead to increasing weakness, loss of independence and other medical problems. Main Line Health interventional radiologists can now offer people suffering from this condition an outpatient, non-surgical treatment that relieves their pain within hours.

What Causes Spinal Fractures?
Spinal fractures occur when a weakened vertebra (a bone in the spinal column) collapses. A simple strain, twisting or bending motion, or fall can cause a fracture. Unlike fractures in other bones which can be “set” with a cast, no such option exists for spinal fractures. Without treatment, it is likely that the fractured vertebra will continue to collapse, leading to increasing spinal deformity - the typical “widow’s hump.”

Approximately 700,000 vertebral or spinal fractures occur each year, usually in people over age 60 suffering from osteoporosis. Younger people can also be affected - those whose bones have become fragile due to the long-term use of steroids or other drugs for diseases such as lupus, asthma, and rheumatoid arthritis.

The Treatment
For people with spinal fractures, few treatments until now have been effective. Bed rest and pain medications have been prescribed, but narcotics can cause unwanted side effects. Surgery has been the treatment of last resort because a weakened bone does not support the necessary metal hardware used to stabilize a spine fracture surgically.

Today, vertebroplasty can offer people a safe remedy that is extremely effective in reducing or eliminating the pain caused by spinal fractures. Most people can resume their normal daily activities within hours.

Guided by fluoroscopy (live, continuous X-ray images), the interventional radiologist inserts two needles into the fractured vertebra through which bone cement is injected.

The cement begins to harden within 15 minutes, preventing further vertebral collapse. Pain normally diminishes within hours-sometimes immediately. The outpatient procedure is performed with a local anesthetic, sometimes with mild sedation. It takes about an hour, and the patient can go home in three to four hours. Studies have shown that from 85 to 90 percent of people treated with vertebroplasty will have complete or significant reduction in their pain, usually within 48 hours.

Kyphoplasty
If regaining heigh of the fractured vertebra is a concern, a variation of vertebroplasty called kyphoplasty is an option, In this procedure, a balloon is inserted into the collapsed vertebral body and inflated, pushing the bones back toward their normal height. Once the balloon is deflated and rmoved, bone cement is then injected into the cavity created by the balloon to stabilize the bone. Kyphoplasty is usually performed under sedation or general anesthesia, often with an overnigh hospital stay.
 

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