Ask the Doctor: New Options Available To Treat Spinal Fractures From Osteoporosis

Osteoporosis, in which bones become fragile and easily broken, causes over 700,000 spinal fractures annually in the U.S.?more fractures than in the hip and wrist combined. Approximately two-thirds of all spinal fractures go undiagnosed or untreated due to the absence of symptoms or difficulty determining the cause of symptoms, leading some to call osteoporosis a ?silent disease.?

Since 50 percent of women and 25 percent of men older than 50 will have an osteoporosis-related fracture in their lifetime and bone loss can begin as early as 30, now is the time to take a closer look at osteoporosis and new options for treating fractures caused by osteoporosis. Through proper diagnosis and treatment, patients with spinal fractures can significantly improve their ability to perform normal activities of daily living and enjoy an overall improvement in their quality of life.

Dr. Steven Garfin, Professor and Chairman, Department of Orthopedics, University of California, San Diego and past-president of the North American Spine Society, offers some answers.

How common is osteoporosis and to what might it lead?
The National Osteoporosis Foundation cites osteoporosis as a major public health threat affecting 44 million Americans. While a calcium-rich diet, weight-bearing exercise and the avoidance of smoking and excessive alcohol can help prevent bone mass loss, osteoporosis ranks second only to cardiovascular disease as a leading healthcare problem according to the World Health Organization.

With osteoporosis, bones in our spine, hip and wrist deteriorate and become susceptible to fractures. In the spine, small fractures lead to compression of the vertebral body (called vertebral compression fractures or VCFs). Left untreated, these VCFs create a curvature of the spine, sometimes referred to as ?dowager?s hump.? Over time, this curvature can become more pronounced, painful and debilitating.

How do I know if I have osteoporosis?
Bone loss happens without symptoms?it doesn?t hurt or cause much trouble at first, though left unchecked it might cause a lifetime of disability and even hasten death. Talk to your doctor about bone health and taking a bone density test.

What happens to you if you have a spinal fracture?
After experiencing one fracture, your risk of a second fracture is greatly increased. In addition, just one fracture affects how weight is distributed through the spine, thus placing higher than normal stress on the front of the spine which contributes to the risk of future fracture. With additional fractures, it can become progressively difficult to walk, eat, and sleep due to pain and the unnatural spinal alignment. See a doctor to determine your condition and appropriate treatment, as there may be different explanations for why you are experiencing back pain.

What options are there if I have a spinal fracture?
Traditional treatments for spinal fractures include extended bed rest, pain medication and back braces, all of which can relieve pain but do not address the deformity caused by the fracture. Open surgery is also an option, but it is more invasive than non-surgical management and is typically reserved for patients with neurological complications. Balloon Kyphoplasty, a minimally invasive procedure, is designed to treat the fracture and restore the vertebra to the correct position. Balloon Kyphoplasty has been demonstrated to significantly reduce back pain, correct spinal deformity and improve quality of life.

How is Balloon Kyphoplasty performed?
Balloon Kyphoplasty is a minimally invasive procedure performed by a spine specialist. It can be performed using either a local or general anesthesia. It typically takes about one hour to treat each fracture and may require an overnight hospital stay.

Does insurance cover Balloon Kyphoplasty?
In most cases, Medicare provides coverage for kyphoplasty. Other insurance may also provide coverage. Check with your insurance carrier or doctor to find out about coverage.

What can Balloon Kyphoplasty do for me if I have a spinal fracture?
If you have a spinal fracture, Balloon Kyphoplasty can restore vertebral body height, significantly reduce back pain and increase mobility, often shortly after the procedure. In addition to pain reduction, patients experience an increased ability to return to such simple, everyday activities as walking, reaching, bending and lifting. Patients also report improved mental health, vitality, social function and emotional health.

Are there risks associated with Balloon Kyphoplasty?
Although the complication rate with Balloon Kyphoplasty has been demonstrated to be low, as with most surgical procedures, there are risks associated with Balloon Kyphoplasty, including serious complications. Complications can include myocardial infarction (heart attack), cerebrovascular accident (stroke), pulmonary embolism (bone cement leakage migrates to the lungs), cardiac arrest (heart stops beating) or nerve or spinal cord injury that may cause pain, weakness or paralysis.

Disclosure: Dr. Garfin is a Scientific Advisory Board member for Kyphon Inc., the manufacturer of devices for performing balloon kyphoplasty.

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. 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), paralysis or muscle weakness, death. Patients should consult with their doctor for a full discussion of risks.