Spine Thoracic

My father just had a vertebroplasty for a vertebral fracture. Because he's so osteoporotic, much of the glue leaked out of the bone. Will this cause even more problems for him?

Vertebroplasty is the injection of a cement-like substance into the fractured vertebral bone. The goal is to strengthen the bone and reduce pain for the patient. With osteoporotic or brittle bones, the cement can leak out.

Problems can occur when this happens. The first problem is that the surgery may be considered a failure. If the cement doesn't give at least a partial repair of the fracture, then the patient may continue to suffer from the pain.

Preventing Cement Leaks During Vertebroplasty

Bone fractures are common in the aging population. Anyone with osteoporosis or bone tumors is especially at risk. Vertebral (spine) fractures are painful and lead to deformity and reduced quality of life. Injecting cement into the fractured spine called vertebroplasty is one treatment option.

My father had some superglue injected into his spine. It’s supposed to help stiffen it up while he was healing from a vertebral compression fracture. He was no sooner home when he got a new fracture two bones below. How often does this happen? Can't they use this superglue before the bones break?

The procedure your father had was most likely called a vertebroplasty. A long thin needle is inserted into the bone. A strong cement or "superglue" is injected into the area. The cement fills in any cracks or fractures that may be present.

New fractures after vertebroplasty are actually fairly common. Doctors aren't sure if this is just a coincidence or not. The patient may have fractured in the new place even without the first fracture.

My mother fell and fractured her spine about two months ago. Despite drugs for pain and physical therapy exercises (which she doesn't do), she hasn't gotten any better. In fact, she's slowly losing her ability to get up and down off the toilet. What can we do?

Talk to her doctor about your concerns. If conservative care hasn't helped in four to six weeks, then surgery may be needed. The fact that she's losing function is a red flag.

If it hurts to move, the average older adult will stop moving. Motion, function, and strength are quickly lost and can be hard to get back. Any further treatment may be less successful because inactivity and decreased mobility has led to deconditioning.

Results of Vertebroplasty Last At Least One Year

The purpose of this study was to see if vertebroplasty can reduce pain and improve function in patients with compression fractures. Vertebroplasty is the injection of cement into the fractured vertebra to reinforce it. The cause of the fracture was osteoporosis related to aging.

My mother fell and fractured her spine in six places. She has such fragile bones they can't do a fusion or put a rod in her spine to hold it in place. The doctors talked about doing a vertebroplasty. They think it should be staged in two or three operations. Why can't they just do it all at one time?

Vertebroplasty is a good treatment option for vertebral fractures. Cement is injected into the bone through a tiny needle. It fills in the cracks of the fracture and helps hold the bone in place until the break can heal with new bone.

There are a few problems though. The cement can leak into the nearby soft tissues. It can put pressure on the spinal cord or spinal nerves. A small piece of cement can enter the blood supply and travel to the lungs causing a blockage like a blood clot.

My father-in-law has a compression fracture in his spine. He's asked me to research his treatment options. I've found out the latest is a minor surgery called vertebroplasty. What can you tell me about it?

Vertebroplasty is the use of cement injected inside the broken bone. It fills up all the cracks of the fracture and hardens to stabilize the bone. The idea was first tried in France in 1984 so it's been around more than 20 years.

My sister says she's got a problem called Thoracic Outlet Syndrome with neck and arm pain. Sometimes there's numbness and tingling in her hand. I suspect she is in an abusive relationship with her boyfriend. Can this syndrome be caused by physical abuse?

It's possible. When patients were surveyed in a recent study most reported a traumatic event as the initial cause of the problem. Car accidents and work-related incidents topped the list. Non-work related events are reported but the specifics aren't really clear.

Whoa! I never thought I'd have to write in for help like this but I need it. I was told I have thoracic outlet syndrome and that's what was causing my neck and arm pain. I had surgery to set the nerves free. I'm not any better. Now the surgeon wants to take a chunk of my rib out. How is that going to help?

We understand your frustration. Thoracic outlet syndrome (TOS) can be very difficult to evaluate and treat. The treatment should match the underlying cause but it's not always possible to know what the real problem is.

When surgery is indicated the surgeon might take a more conservative approach. Removing part of a rib can't be undone so rib-sparing surgery is often tried first. If the patient doesn't improve, then the second more advanced operation is still possible.

Whenever I wear a backpack (even a light one) the area just above my collarbone hurts and my right hand goes numb. What could be causing this?

You may be describing symptoms of a problem called Thoracic Outlet Syndrome (TOS). The major blood vessels and nerves to the arm and hand travel from the neck under the collarbone and down the arm.

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