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
May 2003 Update
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