Procedures offer help for pain of spinal fractures due to osteoporosis

January 15, 2007
Patients with painful spinal fractures due to osteoporosis are finding relief from two procedures that can help shore up their bones. The procedures, vertebroplasty and kyphoplasty, both use an injection of cement to stabilize the compression fracture and keep it from collapsing and causing further damage. Physicians at New Hanover Regional Medical Center say most patients will find their pain significantly reduced after treatment. “Pain relief is generally fairly dramatic,” said orthopedic surgeon Jon Miller, MD. “Many times relief is immediate.” Compression fractures in the spine are often caused by osteoporosis, a condition that weakens the bones and typically affects women. In addition to severe and chronic pain, women with the fractures can lose height and develop a hunchback appearance. Untreated, the condition can deteriorate and lead to numbness, tingling and weakness. “Most people will have a fracture and will heal within four to six weeks,” said interventional radiologist Mark Ragozzino, MD. “But a percentage will get worse with time and not respond to conservative therapy.” Conservative therapy, such as bed rest and pain medication, is the first line of treatment, but can lead to problematic side effects. “The trend is to be more aggressive in treating compression fractures,” said Dr. Ragozzino. “The pain is generally pretty miserable and there is some downside risk to waiting. Older patients on bed rest lose muscle strength and bone mass quickly and a lot of times never recover.” The lack of activity can also lead to bedsores, blood clots in the legs, and pneumonia, he said. “Because we use IV sedation, not general anesthesia, even some of the more debilitated patients can benefit from the procedure,” said orthopedic surgeon Mark Foster, MD. “These sicker patients are just the ones who do not need to experience a period of prolonged bed rest.” Vertebroplasty is done by inserting a hollow needle through the skin and into the area of the fracture. Using X-ray images to guide the procedure, the doctor injects quick-drying bone cement into the damaged bone. “We surveyed the first 170 patients we treated with vertebroplasty,” said Dr. Ragozzino “All of them said their pain was relieved and they would have the procedure done again if they had another compression fracture. Eighty percent obtained 50 percent or more relief of their pain.” Kyphoplasty also uses an injection of cement. With kyphoplasty, however, the doctor inserts a balloon catheter into the vertebra and inflates it to open the collapsed area. The procedure can help restore the spine to a more normal alignment and improve the stooped-over posture that can result from compression fractures. Both procedures are done on an outpatient basis. For a referral to a physician who performs vertebroplasty or kyphoplasty, call VitaLine at 910-815-5188.