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If your bones are weak, everyday activities such as bending over to pick something up or carrying a bag of groceries, can cause the bones in your spine to break. Vertebral compression fractures usually cause severe back pain that comes on suddenly, although sometimes the pain can be dull and chronic in nature. Also, some fractures may be asymptomatic , meaning that you have no symptoms and don't feel any pain at all; however, VCFs don't have to be painful to have a profound effect on your health and well-being. Multiple VCFs can cause your spine to shorten and angle forward, resulting in a stooped or "hunchbacked" posture (kyphosis). Over time, this alteration in posture can have a compression-like effect on your internal organs, causing medical complications seemingly unrelated to your spine. Some of the complications associated with kyphosis include:
It is important that you to talk with your doctor if you have back pain or suspect that you have a VCF. Fortunately, there are treatments that can repair spinal fractures and help you step back into life. 1. Lyles et al, Association of Osteoporotic Vertebral Compression Fractures with Impaired Functional Status, Am J. Med, 1993;94:595-601 2. Schlaich et al, Reduced Pulmonary Function in Patients with Spinal Osteoporotic Fractures, Osteoporosis Int, 1998;8:261-267 3. Silverman, The Clinical Consequences of Vertebral Compression Fracture, Bone, 1992, 13:S27-31 4. Kado et al, Vertebral Fractures and Mortality in Older Women, Arch Intern Med, 1999;159:1215-122
With osteoporosis, the bones of the hip, wrist and spinal column are vulnerable to fracture. A vertebral compression fracture (VCF) occurs when one of the bones that makes up the spinal column break. Multiple VCFs can cause kyphosis, also known as a "dowager's hump." Mistakenly considered a normal part of aging, the stooped posture and chronic pain associated with VCFs contribute to an overall poor quality of life. It's important to know whether or not you have osteoporosis, because with proper diagnosis and treatment, disease progression can be slowed. Risk Factors for Osteoporosis According to the National Osteoporosis Foundation, certain people are more likely to develop osteoporosis than others. Known risk factors are listed below. If you'd like a list of discussion points to refer to when talking to your doctor about osteoporosis, click here .
For more information,visit the National Osteoporosis Foundation Web site: www.nof.org
Another type of kyphosis may develop later in life (especially in women), as a result of primary osteoporosis , from long-term use of steroids, or due to the presence of spinal tumors. As the bones of the spine weaken and become porous, multiple fractures cause the vertebrae to collapse. To a great extent, kyphosis prevention depends on treatment or prevention of the underlying disease. In many cases, particularly those involving osteoporosis, kyphosis can be managed by specially trained healthcare professionals.
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Step 1: Balloon Placement |
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Step 2: Full inflation |
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Step 3: Void created within the vertebral body |
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Step 4: Filling the cavity with cement |
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Step 5: Internal cast |
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Free Kyphoplasty Consultation is offered at our Regents Imaging Location |
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Treatment is done at Tri-City Medical Center |
After the procedure Typical postoperative care involves the following:
After the procedure, you will be transferred to the Recovery Room for about an hour. A specially trained nurse will monitor your condition and assess the degree to which your back pain has been alleviated. During your hospital stay, you will be encouraged to walk and move about. Generally, patients are discharged from the hospital within 24 hours. Your doctor will have you schedule a follow-up visit and explain limitations, if any, on your physical activity. After treatment with Balloon Kyphoplasty, mobility is often quickly improved. Most patients are very satisfied with the procedure and are able to gradually resume activity once discharged from the hospital. After the procedure, the patient should return to the osteoporosis-treating physician for medical management and follow-up. |
Am I at risk for osteoporosis? Could my back pain be caused by a spinal fracture? Is Balloon Kyphoplasty a treatment option for me? You may be asking yourself these questions as you read this Web site. Questions of this nature can only be answered by a doctor, so you may want to print the Physician Visit Checklist below and bring it with you to your doctor's office. To view this file, you need to have Adobe Acrobat Reader. If you do not have this program, you can download it free of charge from Adobe's Web site .
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Free Kyphoplasty Consultation is offered at our Regents Imaging Location |
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Treatment is done at Tri-City Medical Center |
OSTEOPOROSIS / RESULTING SPINAL FRACTURES
Q: What is osteoporosis?
A: Osteoporosis is a condition in which bones become fragile and weak, causing them to break more easily than normal bone. Over 700,000 spinal fractures occur each year in the United States -more than fractures of the hip and wrist combined. Often referred to as the "silent disease," osteoporosis usually progresses without obvious signs or symptoms until the first fracture occurs.
Q: What is a vertebral compression fracture?
A: Fractures of the bones that make up the spinal column are referred to as vertebral compression fractures (VCFs). Multiple VCFs can cause kyphosis, otherwise known as "Dowager's hump", a deformity in the upper part of the back at the spinal curve (between the shoulders). Mistakenly considered a ''normal'' part of aging, the stooped posture and potential chronic pain associated with spinal fractures contribute to an overall poor quality of life. Left untreated, the psysiological and psychological consequences can be devastating.
Q: Are vertebral compression fractures difficult to diagnose?
A: Vertebral compression fractures are under-recognized by physicians and patients alike, and in that respect, they are difficult to diagnose. About two-thirds of all osteoporotic spinal fractures are not diagnosed. A person may have a spinal fracture and not have symptoms. On the other hand, a person with a spinal fracture may consider the discomfort simply "back pain," and not realize the importance of having the source, or reason for the pain, correctly diagnosed.
A complete physical exam, together with an x-ray and MRI, can help your physician distinguish between pain caused by a vertebral compression fracture or something else. Also, it's important to know whether or not you have osteoporosis, because with proper diagnosis and treatment, the disease progression can be slowed.
Q: How does a VCF occur?
A: Disease or an injury can cause the vertebrae to either partially or completely collapse. After an initial vertebral fracture, the risk for having another fracture is increased fivefold. In addition, just one VCF affects the distribution of weight along the spinal column. Misalignment brought on by a fractured vertebra places more stress on adjacent vertebrae; the front of the spine has to withstand the same amount of stress or weight, with fewer functioning parts, resulting in a structure that is now weakened and more vulnerable to additional fracture.
Q: What are the symptoms of a VCF?
A: Most VCFs have a gradual onset, unrelated to a specific injury. Fractures occur as a result of normal activity; i.e., bending over to pick something up, reaching toward something or carrying a bag of groceries. In some cases, a patient will experience sudden and severe pain. The fact that symptoms of a spinal fracture can be easily confused with other back problems underscores the importance of obtaining a correct diagnosis and receiving treatment.
Q: Can vertebral fractures adversely affect my overall health?
A: Over time, multiple VCFs can cause kyphosis, which, in turn, can become more pronounced, painful and debilitating. Forward curvature of the spine has a "compression effect" on your organs, making it progressively difficult to breathe, walk, eat or sleep properly. Lung capacity is reduced, mobility is limited, early satiety occurs and sleep disorders are common. Women over age 65 with prevalent VCFs have a 23-34% increase in mortality, compared to similar aged women without VCFs.[1]
[1] Kado, et.al. Arch Int. Med. 1999;159:1215-1220
Q: What are the psychosocial effects of VCFs?
A:Studies have shown that compression fracture patients experience depression, anxiety and lowered self-esteem, in addition to medical complications. The alteration in lifestyle that accompanies severe kyphosis profoundly affects a patient's sense of well-being and causes feelings of isolation and sadness.
Q: Who is at risk for suffering an osteoporosis-related fracture?
A: The National Osteoporosis Foundation indicates that 50% of women and 25% of men older than 50 will have an osteoporosis-related fracture in their lifetime; however, bone loss in women can begin as early as age 30. Additionally, long-term use of medications such as corticosteroids can cause loss of bone mass.
Q: Is osteoporosis preventable?
A: A calcium-rich diet, weight-bearing exercise and avoidance of smoking and excessive alcohol can help prevent loss of bone mass.
Q: What are some risk factors for osteoporosis?
A: The National Osteoporosis Foundation has identified the following as risk factors:
- Family history of osteoporosis or fractures (in a close relative)
- Broken bone after age 50
- Loss of more than 3 cm (just over 1 inch) in height
- Low calcium in diet
- Smoking, excessive alcohol consumption or certain medications (i.e., glucocorticoids)
- Normal or early menopause (before age 45)
- Low testosterone in men
Q: How prevalent is osteoporosis?
A: The National Osteoporosis Foundation cites osteoporosis as a major public health threat affecting 44 million Americans, or 55 percent of the people 50 years of age and older. One in two women and one in four men over age 50 will have an osteoposis-related fracture in her/his remaining lifetime.
BACK PAIN AND VCFS
Q: How does normal back pain compare with the pain of a VCF?
A: It is important to determine the underlying cause of back pain. There are many reasons for back pain, but only a complete physical exam, x-rays, and MRI can determine whether or not a VCF is present. Sudden, severe back pain unrelated to specific injury may indicate that a VCF has occurred.
Q: What can happen if a VCF isn't diagnosed and treated?
A: Left untreated, one fracture can lead to another, resulting in kyphosis and a "downward spiral" in health status. Kyphotic deformity and progressive bone loss increases your risk for more fractures, in addition to adversely affecting your ability to breathe, move about, eat, and sleep. Consult with your physician to determine your condition and appropriate treatment.
BENEFITS OF KYPHOPLASTY / OVERVIEW OF PROCEDURE
Q: How have VCFs been treated in the past?
A: Traditional treatment for VCF includes extended bedrest, pain medication and back braces. These treatments can relieve pain, but they do not stabilize the fracture or correct the related deformity.
Q: How long does the Balloon Kyphoplasty procedure take? What type of anesthesia is used?
A: On average, the procedure takes about one hour per fracture treated, and may require an overnight hospital stay. Kyphoplasty can be performed using either local or general anesthesia; the physician will recommend the most appropriate anesthesia based on the patient's general condition. After the procedure, the physician will schedule a follow-up visit and explain limitations, if any, on physical activity.
Q: Is Balloon Kyphoplasty covered by insurance?
A: In most cases, Medicare provides coverage for kyphoplasty. Other insurance plans may also provide coverage. Consult with your physician and insurance company to determine coverage for your particular situation.
Q: What are the potential benefits of Balloon Kyphoplasty?
A: Kyphoplasty has been shown to achieve restoration of vertebral body height and correction of spinal deformity with a low complication rate.
Patient outcomes include:
- Significant reduction in back pain
- Significant improvement in quality of life
- Significant reduction in number of days per month that a patient remains in bed
- Significant improvement in mobility
- Improved ability to perform activities of daily living, such as walking, hobbies and work
- Significant reduction in number of days per month when pain interfered with daily activities
Favorable patient outcomes have been shown to last through two-year follow-up. Studies that document benefits beyond two-year follow-up have not yet been reported.
(Kyphon U.S. Multicenter Prospective Single Arm Study. Data on file at Kyphon Inc.)
Q: Are there risks associated with Balloon Kyphoplasty?
A: As with any surgery, there are potential risks. Although Balloon Kyphoplasty is designed to minimize these risks as much as possible, there is a chance that complications could occur. Although the complication rate is low, serious adverse events can occur, including:
. myocardial infarction (heart attack)
. cerebrovascular accident (stroke)
. pulmonary embolism (cement leakage that migrates to the lungs)
. cardiac arrest (heart stops beating).
Patients should consult with their doctor for a full discussion of the risks.
Q: What can patients expect after a Balloon Kyphoplasty procedure?
A: Published studies cite a marked reduction in pain, sometimes within hours of the procedure.
Balloon Kyphoplasty has been shown to improve mobility and enable patients to return to everyday activities such as walking, bending and lifting, with significantly less pain than they had prior to the procedure. Patients report improved mental health, vitality, social function and emotional well-being.
Q: Can a VCF that occurred a long time ago be treated with Balloon Kyphoplasty?
A: Age of the fracture and treatment success varies from patient to patient; however, physicians generally agree that the earlier a fracture is treated, the better the outcome will be.
Q: Can Balloon Kyphoplasty help me if I have crushed vertebrae due to an accident or fall?
A: If you have osteoporosis, lifting a child or tripping on a curb can cause a compression fracture. Osteoporotic fractures can also occur spontaneously, unrelated to an accident. Unremitting back pain alone can be a sign of a VCF, although every situation is unique and should be evaluated by your physician.
Q: How many Balloon Kyphoplasty procedures have been performed?
A: Over 175,000 fractures in 150,000 patients worldwide have been treated with Balloon Kyphoplasty.
THE COST OF VERTEBRAL COMPRESSION FRACTURES
Q: What are the healthcare costs associated with the treatment and hospitalization of compression fracture patients?
A: Approximately 150,000 people in the U.S. are hospitalized each year due to pain and medical management associated with spinal fractures.
The estimated national direct expenditure (hospitals and nursing homes) for osteoporotic and associated fractures was $17 billion in 2001 ($47 million each day), and the cost is rising, according to the National Osteoporosis Foundation.
Information granted by www.kyphon.com . Please visit the website for additional resources.
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Free Kyphoplasty Consultation is offered at our Regents Imaging Location |
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Treatment is done at Tri-City Medical Center |