Almost one million adults in the United States suffer vertebral compression fractures (VCFs) each year. When that many people are affected by a condition, doctors and scientists take a closer look to see what can be done to improve treatment and save money.
A group of neurosurgeons from The Johns Hopkins Medical Center just published a systematic review on the treatment of vertebral compression fractures using vertebroplasty and kyphoplasty. These procedures have been around for a while now so there’s some convincing evidence that they work well.
A systematic review means they searched all the published literature for articles on the use of vertebroplasty or kyphoplasty for vertebral compression fractures. They reviewed the design of the study and the level of evidence (poor-fair-good-excellent or insufficient) and reported on the results for three different conditions: osteoporosis-, trauma-, and tumor-induced compression fractures.
A vertebroplasty is done by making a small incision in the skin on each side of the spinal column. A long needle is inserted through each opening. The surgeon slides the needles through the back of the spinal column into the fractured vertebral body.
A fluoroscope is used to guide the needles. This is a special X-ray television camera adjusted above the patient’s back that lets the surgeon see the patient’s spine on a screen. Metal objects show up clearly on X-rays. The needles are easy for the surgeon to see on the fluoroscope screen. This helps the surgeon confirm that the needles reach the correct spot.
Once the needle is in place, special acrylic bone cement is injected through the needle into the fractured vertebra. A chemical reaction in the cement causes it to harden in about 15 minutes. This fixes the bone so it can heal. Bandages are placed over the small openings where the needles were inserted.
A kyphoplasty is done with the same minimally invasive technique. But instead of a needle injecting cement into the bone, a hollow tube with a deflated balloon on the end is slid into holes drilled in the vertebrae. The balloons are inflated with air. This restores the height of the vertebral body and corrects the kyphosis (hunchback) deformity that can occur with vertebral compression fractures. Then surgeon removes the balloon and injects bone cement into the hollow space formed by the balloon. Once the cement hardens, the bone is held in its corrected height and position.
Your mother may be a good candidate for a kyphoplasty. The evidence suggests that for those who suffer back pain, this procedure reduces/eliminates that pain right away. For those who are limited by deformity, physical function and mobility are often restored. Make an appointment with her physician to discuss your concerns and this (and other) treatment options.