Osteoporosis is a disease process that involves inadequate mineralization and weakening of bone. This disease is prevalent in the US, affecting women more than man, and individuals of both sexes as we age.
This process can be treated medically with medicines that promote bone mineralization. Despite this, patients who suffer from osteoporosis often develop fractures of spine vertebras because their demineralized bones are weak and more prone to break even with normal activities of daily living. These fractures affect an estimated 25% of all postmenopausal women and 40% of women age 80 and older.
Once a fracture occurs, the spine alignment may be altered, nerves that arise from the spinal cord at the level of the fracture may become compressed, and the added weight on the fractured vertebra all contribute to generating severe back pain. The initial treatment of these so called “compression fractures” of the spine is with analgesic (pain killer) medication. However, a significant number of patients continue to have severe pain and disability.
Vertebral Augmentation Procedures
Over two decades ago, a radiological procedure called Vertebroplasty was first used to treat compression fractures of the spine secondary to osteoporosis. A relatively newer procedure called Kyphoplasty was then also developed for the same purpose. These procedures entail guiding a special needle under imaging guidance through the soft tissues of the back and then into the fractured vertebra.
Once in the body of the vertebra, bone cement is injected until good filling of the bone is obtained. In Kyphoplasty, prior to injecting the bone cement, inflating a balloon inside the bone makes a cavity. This aims to achieve more controlled cement injection into the bone. These procedures are performed by Interventional Radiologists in an outpatient setting under local anesthesia and intravenous sedation, with no need for hospitalization and discharge home from the outpatient center in about two hours. Approximately 85-95 percent of patients report significant to complete pain relief. The results of the procedure can be dramatic, as some patients experience complete pain resolution at the conclusion of the procedure.
Treatment of Painful Spine Metastasis
Many cancers may spread to bone, including the spine. These metastatic spinal lesions may cause significant pain because of tumor related effects, like releasing chemicals that stimulate pain pathways to our brain, directly compressing nerves and causing weakening of the bone that can lead to compression fracture. Recently, a new procedure for the palliation of painful metastatic spine lesions has been approved for use in Sylvester facilities.
Like Vertebroplasty/Kyphoplasty, the procedure consists in percutaneously accessing the vertebral body under imaging guidance. Once this is achieved, a special radio frequency probe is advanced through the access needle into the vertebral body and the tumor is ablated or “burned”. The vertebral body is then filled with bone cement to achieve stability if there is already a fracture or to prevent future compression fracture. This procedure is a good alternative for patients who cannot or do not want to receive radiation therapy to alleviate pain secondary to spinal metastasis.
Why Choose UHealth?
Expert care from highly trained interventional radiologists. Our interventional radiologists and radiology specialists are experts in a variety of minimally invasive procedures — everything from treatments to clear blocked blood vessels to advanced cancer therapies like NanoKnife®.
Leading-edge imaging care in South Florida. Our doctors are also researchers discovering new ways to improve diagnosis and treatment. That means you can get some of today’s most promising advancements through clinical trials. You benefit from the latest developments that are fast-tracked from the lab to the bedside.