"Osteoporosis is a thinning and weakening of the bones that increases the chance of fractures," explained Neurosurgeon Joel Siegal, M.D.
"Along with hip and wrist fractures, severe osteoporosis can cause compression fractures in the spine. This occurs when the bony block in the spine, known as the vertebral body, collapses and causes severe pain, deformity and loss of height. It can also lead to nerve compression.
"Spinal fractures resulting from osteoporosis often occur while doing something that causes relatively minor trauma to the spine, such as opening a window or twisting while lifting," Dr. Siegal advised. "Advanced cases of osteoporosis can lead to a vertebral fracture as a result of routine activities that would normally not cause any trauma, such as sneezing, coughing or turning over in bed.
"After a vertebra has fractured, there is typically a loss of 20 to 30 percent of the height of the bone. Over several weeks, further compression or collapse of bone may increase and the vertebra can flatten out, until there's a 70 to 90 percent loss of height in the bone. Gradually, the back hunches over, called kyphosis or stooped posture, and the person loses height, especially if several vertebrae are involved. For many people, severe back pain persists because the crushed bone continues to move and break."
"Until the last decade, doctors were limited in how they could treat osteoporosis-related spine fractures," Dr. Siegal stated. "Pain medications, bed rest, bracing or invasive spinal surgery were the primary options available. Today there are two promising treatments for compression fractures, called vertebroplasty and kyphoplasty.
One in two women and one in four men over the age of 50 will have a fracture related to osteoporsosis during their lifetime. Studies show that a first osteoporotic fracture makes it five times more likely that further fractures will occur.
Symptoms of vertebral
fractures may include:
- Sudden onset of back pain
- Standing or walking usually makes the pain worse
- Lying on one's back makes the pain less intense
- Height loss
- Limited spinal mobility
- Deformity and disability
Compression fractures from osteoporosis don't just occur in the elderly, they can also occur in people as young as 40 or 50 years old.
"Vertebroplasty and kyphoplasty are considered to be minimally invasive procedures, meaning that open surgery is not required. These procedures are used to treat osteoporotic fractures by injecting a cement-like material directly into the weakened or fractured bone.
"Vertebroplasty literally means fixing the vertebral body. This procedure can be used to strengthen the vertebral bodies once they have fractured. Kyphoplasty includes an additional step beyond vertebroplasty. Prior to injecting the cement-like material, a special balloon is inserted and gently inflated inside the fractured vertebrae. The goal of this step is to restore height to the bone thus reducing deformity of the spine. Often, more than one crushed vertebra can be treated in a single procedure, which is usually performed on an outpatient basis. Most people can return to their normal daily activities after either procedure."
"The results of these procedures show that there is about a 90-95 percent improvement in pain relief, and most people are happy with the outcome in less than 24 hours," Dr. Siegal remarked. "There is also often significant improvement in a person's ability to function following treatment. This is due to the stabilization of the bone, which prevents further collapse and relieves the pain. The injection not only expands the compressed vertebra to a degree, but helps to stop the pain caused by bone rubbing against bone.
"With these advanced techniques, the best results are obtained in the first three months after the onset of pain from a fracture. People treated soon after a fracture seem to have better results, compared to those whose treatment is delayed for more than three months.
"These procedures have also become safer and much more effective, not only for the control of pain, but also for preventing further collapse of the softened bones of the spine," Dr. Siegal concluded. "If performed early enough, they can help prevent kyphosis or a permanent disability resulting from the inability to straighten the spine. In addition, the procedure can be performed in some cases for cancer patients, who are suffering from spinal collapse."
Additional benefits of these procedures include:
- Shortened surgical time
- Anesthesia is usually minimal
- Average hospital stay is one day or less
- People can quickly return to the normal activities of daily living
- No bracing is required
For more information about vertebroplasty and kyphoplasty, contact Dr. Siegal at 877.98.SPINE (877-987-7463). Dr. Siegal is a member of Salem Community Hospital's medical staff, where he conducts a monthly neurosurgery clinic. He is also affiliated with the Spine and Orthopedic Institute at St. Vincent Charity Medical Center.