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.
