By: Jean Johnson for Back1“Approximately 700,000 vertebral, or spinal bone, fractures occur each year – usually in women over the age of 60,” notes the Society of Interventional Radiology (SIR) literature. “Of particular concern are spinal fractures caused by a progressive weakening of the bone – a condition called osteoporosis.”
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How Osteoporosis and Back Pain
As people age, calcium and phosphate may be reabsorbed back into the body from the bones, which can result in brittle, fragile bones likely to fracture, even in the absence of physical trauma.
Usually, the bone loss occurs gradually over years. Many times, a person will have a fracture before realizing that they have osteoporosis.
A fracture from osteoporosis is one of several common sources of lower back pain. Other sources of low back pain are:
Muscle spasm
Ruptured or herniated disk
Poor alignment of the vertebrae
Spinal stenosis (narrowing of the spinal canal)
Strain or tears to the muscles or ligaments supporting the back
Spine curvatures (like scoliosis or kyphosis) which may be inherited and seen in children or teens
Other medical conditions like fibromyalgia
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The cost of treating vertebral fractures in the United States was $746 million in 1995, according to a 2002 article by Thomas A. Predey, M.D. and colleagues published in the American Family Physician. “With an increasing life expectancy and the aging of the ‘baby boomer’ generation,” Predey wrote, “the incidence and costs of osteoporosis are expected to increase substantially.” “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,” adds the SIR. “For many people with osteoporosis, a spinal fracture means severely limited activity, constant pain and a serious reduction in the quality of their lives.”
Also, while fractures of the hip and wrist are relatively easy to treat with surgery, risky and difficult surgical procedures on the spine have typically been used only as last resort in treating vertebral fractures associated with osteoporosis and other causes like excessive steroid use.
How Vertebroplasty Works
Vertebroplasty (ver-TEE-bro-plasty) takes between 15 minutes to four hours and requires a post-op recovery of anywhere from one hour to several days in the hospital. Using a type of X-ray called fluoroscopy that provides real time images of the inside of the body, interventional radiologists can carefully inject acrylic bone cement directly into the fractured vertebra, thus stabilizing the bone. The procedure can treat more than one vertebra at a time which is useful since patients often have multiple fractures.
Success Rates
“The success rate for this procedure [vertebroplasty] in treating osteoporotic fractures is 73 to 90 percent,” wrote Predey who adds that this treatment is one of the newer techniques to emerge in the field of interventional radiology in the past several years. Further, Predey’s study stated “most patients [were able] to discontinue or significantly decrease analgesics and resume normal activity.”
An interventional radiologist who uses vertebroplasty, Jeremy Weiss, D.O. and medical director of the Portland Endovascular and Interventional Radiology Center, puts his comments in less abstract terms.
“I’ve seen numerous patients come in severely crippled up with pain. After the procedure and post-op care, they are able to get up and walk right out of our office,” said Weiss. “It’s that effective.
“So vertebroplasty can make highly significant and dramatic changes in patients’ quality of life. And as with all the minimally-invasive procedures we do in the field of interventional radiology, there is less risk than traditional surgery and the recovery process is considerably shorter than with traditional surgery.”
The SIR literature concurs with Predey and Weiss. “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.”
Pain free in a matter of hours? If it seems too good to be true, thank the people pioneering the field of interventional radiology. Indeed, the future of medicine is here.
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