In India, more than 5 crore people suffer from osteoporosis, and with age the bone mineral density decreases leading to thinning of bones. This raises the risk of bone fractures, especially in the spine. Though thinning of the bones can occur at any time, but is most common in elderly persons. “Compression” fractures are caused when the weakened bone of the spine collapses and causes severe back pain. When several of the bones collapse, loss of height or stooped posture may occur. In most of the patients, the pain continues because the crushed bone continues to move and break.
Most fractures of the spine are treated with bed rest until the pain goes away. Pain medicines, back braces and physical therapy may also be used. Sometimes, patients may need surgery to secure the spine using a bone graft or an internal metal device. Recently, a new non-surgical treatment called “vertebroplasty” is being used to help hold the fractured bone in place and relieve pain. Patients who are unresponsive to conservative therapy of bed rest, analgesics, and back bracing should be considered for vertebroplasty.
Vertebroplasty is a newer non-surgical technique in which medical grade cement is injected through a needle into a painful fractured vertebral body. This stabilizes the fracture, allowing most patients to discontinue or significantly decrease analgesics and resume normal activity. Vertebroplasty is also useful in painful or unstable benign and malignant vertebral lesions that fail to respond to the traditional conservative therapies like multiple myloma, hemangioma and various spinal bone cancer.
Many patients feel pain relief right away after vertebroplasty. Most report that their pain is gone immediately after the procedure and the patient is able to resume to normal activity within a day. Vertebroplasty is very safe. The bone cement used to secure the broken bone is safe. If you have significant back pain caused by a broken bone (osteoporotic fractured vertebra) in your back that is not getting better after one to two weeks of bed rest and pain control medicine, you may need vertebroplasty. Newer fractures tend to respond better than older fractures; however, some older fractures can be treated successfully. The success rate for this procedure in treating osteoporotic fractures is about 90-95%. Vertebroplasty can effectively treat aggressive hemangiomas of the vertebral body and may be palliative in patients with malignant pathologic fractures.
What are the advantages of Vertebroplasty?
Decreased pain: Vertebroplasty reduces and in some cases eliminates the need for pain medication, and it also restores mobility in many patients.
Increased functional abilities: Vertebroplasty stabilizes the fracture, decreases pain dramatically and allows a return to the previous level of activity.
Prevention of further vertebral collapse: The cement fills spaces in bones made porous by osteoporosis, strengthening the bone so that it is less likely to fracture again.
No risk of infections: As the procedure is done through 3 mm incisions, the healing is very fast and no complications or infections are involved.
No anesthetic effect: It is done under local anesthesia so no complication of total anesthesia.
Daycare procedure: More over it is a fast procedure so the surgery time is very less (<30 minutes). And as the cement hardens quickly and pain reduces immediately patient is able to walk after a few hours of the procedure and can go home the same day.
(The Author is Head of Mumbai Spine Scoliosis & Disc Replacement Centre, Bombay Hospital, Mumbai)
