|New Treatment for Osteoporosis-Related Spinal Fractures Provides Immediate Relief |
By Rallie McAllister, M.D., M.P.H.
Rose Mary Brannon, an active, 78-year-old great-grandmother, has advanced osteoporosis, but she wasn't even aware of her condition until last year. The first sign of trouble was a sudden, severe pain in her midback and abdomen.
"I was doing my housework one morning, and I felt a terrible pain in my back, right between my shoulders," she said. After a trip to her family doctor and a few X-rays, Rose Mary was diagnosed with a spinal fracture caused by osteoporosis.
For the 44 million Americans currently suffering from osteoporosis, the risk of sustaining a spinal fracture is very real. The National Osteoporosis Foundation estimates that more than half of American women and a fourth of American men over the age of 50 will experience at least one spinal fracture in their lifetimes.
The vast majority of these fractures will be vertebral compression fractures. Although the fractures are most common in people with osteoporosis, they may also occur in individuals with tumors of the spine.
According to John Ledlie, M.D., a neurosurgeon at Tyler Neurosurgical Associates in Tyler, Texas, "A vertebral compression fracture causes a flattening of one of the back bones. It's like taking an empty soda can, standing it upright, and then stepping on it."
Remarkably, the fractures can occur in the absence of any type of trauma. "In individuals with weak or soft bones," Ledlie explained, "just doing something as simple as reaching up to get a can off a shelf can cause one of the backbones to fracture."
People who suffer vertebral compression fractures typically experience sudden, severe pain in a single location on the spine. In most cases, twisting, turning and standing worsen the pain, and lying down may provide only partial relief.
In the past, treatment options were limited. Most patients were fitted with supportive back braces, prescribed narcotic pain medicines and put on bed rest for weeks or months.
"Those types of treatments weren't very good solutions," Ledlie noted. "The bed rest and braces helped improve the fractures, but they actually accelerated the osteoporosis and made it worse over the long run."
Although a fractured backbone can eventually heal, it heals in a collapsed state, leading to a curvature of the spine commonly known as a dowager's hump. The dowager's hump, in turn, can cause additional problems, including difficulty walking, eating and even breathing properly.
Fortunately, a new procedure called balloon kyphoplasty is now available for the treatment of vertebral compression fractures. Balloon kyphoplasty is a minimally invasive surgery that uses small, orthopedic balloons and surgical cement to repair the fractured backbone.
The procedure involves making two tiny stab wounds, each measuring less than a quarter of an inch, over the spine. Using a surgical probe, a balloon is inserted into the collapsed backbone and then inflated.
Once the vertebra is expanded and in the correct position, the balloon is deflated and removed, leaving a cavity within the bone. The cavity is then filled with fast-drying bone cement, which forms an internal cast that holds the bone in place.
Balloon kyphoplasty takes about an hour to perform, and the surgeon may opt to use either local or general anesthesia. Depending on the patient's overall condition, an overnight hospital stay may be required.
The results of a study published recently in the medical journal "Spine" concluded that balloon kyphoplasty resulted in significant vertebral height restoration for at least two years following the procedure. Ledlie, who conducted the study, followed the progress of 100 patients for two years after they had undergone balloon kyphoplasty.
"Prior to their surgery, 75 percent of the patients were in wheelchairs or had to be supported while walking," the neurosurgeon said. "A week after the surgery, the majority of patients were either walking around on their own or walking with only minor assistance."
Not only was the patients' mobility markedly improved, their pain was significantly reduced just one day after surgery. In the majority of cases, pain relief was maintained over a two-year period.
A few weeks after sustaining a vertebral compression fracture, Rose Mary Brannon underwent balloon kyphoplasty. "Right after the surgery, I was able to sit up in bed by myself, and the pain was gone," she said.
Ledlie said Rose Mary's results are typical. "It's very rewarding to do this procedure, because patients are already better as soon as the surgery is finished," he said. "They don't have to take pain medicines or wear back braces; they're able to go home and get back to a normal life."
Rallie McAllister, M.D., M.P.H., is a family physician in Kingsport, Tenn., and author of "Healthy Lunchbox: The Working Mom's Guide to Keeping You and Your Kids Trim." Her Web site is http://www.rallieonhealth.com. To find out more about Rallie McAllister, M.D., and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com.