A New, Interventional Radiology Treatment for the
Pain of Spinal Fractures Caused by Osteoporosis
Approximately 700,000 vertebral, or spinal bone, fractures occur each year – usually in women over the age of 60. Researchers estimate that at least 25 percent of women and a somewhat smaller percentage of men over the age of 50 will suffer one or more spinal fractures. Younger people also suffer these fractures, particularly those whose bones have become fragile due to the long-term use of steroids or other drugs to treat a variety of diseases such as lupus, asthma and rheumatoid arthritis. Of particular concern are spinal fractures caused by a progressive weakening of the bone, a condition called osteoporosis. The pain and loss of movement that often accompany bone fractures of the spine are perhaps the most feared and debilitating side effects of osteoporosis. For many people with osteoporosis, a spinal fracture means severely limited activity, constant pain and a serious reduction in the quality of their lives. Fractures of the vertebrae have traditionally been much more difficult to manage than broken bones in the hip, wrist or elsewhere. These broken bones can often be successfully treated with surgery. But because surgery on the spine is extremely difficult and risky, it has typically not been used to treat vertebral fractures associated with osteoporosis except as a last resort. Until recently, reduced activity and pain medications, many of which cause problematic side effects, or invasive (and often unsuccessful) back surgery were practically the only treatments available. Today, however, there is a safe, nonsurgical interventional radiology treatment called vertebroplasty that has been shown to be extremely effective in reducing or eliminating the pain caused by spinal fractures.
Vertebroplasty is a pain treatment for vertebral compression fractures that fail to respond to conventional medical therapy, such as minimal or no pain relief with analgesics or narcotic doses that are intolerable. Vertebroplasty, a nonsurgical treatment performed using imaging guidance by interventional radiologists, stabilizes the collapsed vertebra with the injection of medical-grade bone cement into the spine. This improves pain, and can prevent further collapse of the vertebra, thereby preventing the height loss and spine curvature commonly seen as a result of osteoporosis. Vertebroplasty dramatically improves back pain within hours of the procedure, provides long-term pain relief and has a low complication rate as demonstrated in multiple studies.
A fractured vertebra can heal in a compressed or flattened wedge shape. Once this occurs, the compression fracture cannot be treated effectively. Kyphoplasty involves inflating balloons in a fractured vertebra prior to the delivery of cement, with the goal of height restoration. It is very important for someone with persistent spinal pain lasting more than three months to consult an interventional radiologist, and people who require constant pain relief with narcotics should seek help immediately.
In vertebroplasty, a needle about the width of a cocktail straw is inserted through the skin into the fractured bone. A bone cement is injected. The cement hardens, stabilizes the bone and prevents further collapse. This stops the pain caused by bone rubbing against bone.
Reprinted with permission of the Society of Interventional Radiology © 2004, www.SIRweb.org. All rights reserved.