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Vertebroplasty and Kyphoplasty

When the vertebrae of your spine are thinned by osteoporosis, simple daily activities such as bending over may cause compression fractures. The pain that can result is debilitating and the collapsed bone thins the spine, leading to the stooped appearance associated with osteoporosis. If you suffer from this condition, you are not alone; every year 700,000 Americans develop osteoporotic compression fractures. For years the method of treating this condition involved pain medications and bed rest followed by bracing and exercise. Within the last ten years, though, two surgical procedures have been gaining popularity and the results of two recent studies seem promising.

In one study, researchers interviewed 245 patients who had undergone vertebroplasty. This procedure involves injecting cement through a tube placed into the vertebra. The cement serves to strengthen the bone. Patients in the study reported a decrease in pain after the procedure: on a 10-point scale, the pain before surgery was an average of 8.9 and afterward an average of 3.4. Seventy-two percent of the patients had difficulty walking before surgery compared to only 28% afterward. In addition, nearly all of the participants were unable to or had difficulty performing activities of daily life before the vertebroplasty, but afterward a majority of patients felt little or no pain while going about their daily activities.

In a second study, researchers reviewed the medical charts of 96 patients who had undergone kyphoplasty. In this procedure, surgeons use a balloon-like device to expand the collapsed vertebra and then inject cement into the bone. Patients in the study reported that their pain dropped from an average of 8.6 (on a 10-point scale) beforehand to 2.1 one month later. Eighty-four percent of the patients were able to walk normally after the surgery, compared to only 35% before. In addition, x-rays from some of the patients’ charts showed kyphoplasty almost fully restored the vertebral height.

These results sound good. But it’s important to note that both studies had relatively short follow-up periods and neither study involved control subjects. In addition, both studies relied heavily on patients’ memories of their pain and discomfort. Certainly further studies are warranted. Despite this, it is worth talking to your doctor about these procedures if the other methods of treatment are not working.

Sources: Radiology, February 2003 and Journal of Neurosurgery, January 2003

May 2003 Update

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