Vertebroplasty Treatment for Osteoporotic Spinal Fractures
What is an osteoporotic vertebral fracture?
Osteoporosis is the medical term for thinning bones and commonly occurs with ageing. The condition is more common in women than men. It is a silent condition that can be present for years and only declares itself when a bone is broken, and when the pain is intense. The fractures can occur in the bones of the spine (vertebrae), as well as in the hip and elsewhere. When a fracture occurs in a vertebra this is known as a 'crush' fracture as the vertebra wedges forward. Apart from being very painful you may notice that your body has suddenly changed shape with loss of height and increased prominence of the abdomen. The pain from vertebral fractures is often severe. It can settle of its own accord over several weeks, but can also persist for many months or longer.
How it is usually treated?
Usually patients are given pain relief medicine and medication to improve bone density and told to rest in bed.
The New Treatment.
A new treatment for persistent pain after osteoporotic crush fractures has been developed. This involves injecting a small volume (1-3ml, about a teaspoon) of bone cement into the fractured vertebra via a needle introduced through the skin under Xray control. This can be done under sedation or general anaesthetic if you chose. The technique has been around for about 10 years for treatment of bone cancer but has only recently been used for fractures due to osteoporosis.
What do I have to do?
There are no restrictions on your activity after this treatment. All patients will be asked to continue on their existing osteoporosis medications throughout.
What are the possible benefits of vertebroplasty?
This new technique offers the possibility of better pain relief from vertebral fractures due to osteoporosis, compared to existing therapies. It may also enable you to reduce or stop pain relief medications.
What are the possible risks of vertebroplasty?
Vertebroplasty involves injection of small amounts of bone cement into the fracture. The bone cement is initially liquid but rapidly hardens after injection. The only possible risk is if bone cement leaves the bone in its liquid form and enters the canal that carries the nerves to the legs. This could cause leg pain and possibly weakness, and even paralysis. This complication has not occurred in the UK when this technique has been used for osteoporotic fractures, so this complication would be expected to be very rare. We make every effort to make sure this does not occur by careful injection under direct X-ray vision. In the very unlikely event this complication did occur, you may require a scan of your back and possibly removal of the cement by surgery, which would be expected to resolve any complications as described above. Vertebroplasty appears to be relatively simple and safe. There have been over 2000 done in UK now with no report of major complication (figures from 2006).