My elderly parents live 1,000 miles away from us. Mom called and said that Dad has a compression fracture at L3. The doctor is advising a wait-and-see approach. We've done some Internet research and think that Dad should have a vertebroplasty. Why hasn't this already been suggested to my parents? When I asked them, they had never heard of it before.
A treatment procedure called vertebroplasty was developed about 15 years ago. A long, thin tube called a cannula (needle) is inserted through the skin into the vertebral bone. Cement is injected through the needle into the compressed area. The cement hardens quickly and stabilizes the fracture. The surgeon uses a special X-ray imaging called fluoroscopy to guide the needle and ensure accurate placement of the cement.
Studies are showing that percutaneous vertebroplasty works well for the treatment of VCFs. It reduces pain, maintains the height of the vertebral body, and can prevent serious health problems. The majority of patients with vertebral compression fractures who have a vertebroplasty do well. The procedure reduces their back pain and this, in turn, increases their movement and speeds up their return to daily function. Nine out of 10 patients are able to reduce (or stop) taking pain relievers.
But not everyone can have this procedure. If the fracture is stable and isn't causing any symptoms, the surgeon may adopt a wait-and-see approach. There's no sense in subjecting a patient to the expense of a procedure that's not really needed.
Alternately, anyone with cancer causing the vertebral compression fracture and collapse may not be a good candidate for vertebroplasty. The risk of cement leakage is greater when bone has been eaten away by cancer. And cement leaking into the spinal canal can cause further problems. This doesn't mean that cancer patients can't have a vertebroplasty. Vertebroplasty for cancer patients must be evaluated on an individual basis.
Vertebroplasty can't be done if a bone fragment from the fracture has shifted or moved into the spinal canal or is pressing on the spinal cord. And there are some patients who are allergic to the bone cement.
There may be an important reason why vertebroplasty hasn't been offered to your father as a possible treatment option. It's reasonable to ask if he might be a good candidate for this procedure. The physician may have discussed this with your parents. Sometimes patients and family members don't catch all that is said during their appointment. It never hurts to ask for further information.
Paul J. Lynch, MD, DABA, and Nicole E. Berardoni, MD. Pecutaneous Vertebroplasty: An Effective Intervention for the Treatment of Vertebral Compression Fractures. In Pain Medicine News. December 2008. Vol. 6. No. 9. Pp. 85-92.
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