Vertebral (Spinal) Compression Fractures: Clinical Consequences and Balloon Kyphoplasty

Osteoporosis causes more than 700,000 spinal fractures each year in the United States, more than twice the annual number of hip fracture cases, according to the National Osteoporosis Foundation. During a vertebral compression fracture (VCF), the cortical bone buckles and cracks while the cancellous bone collapses and becomes compacted, thereby reducing the overall height and volume of the vertebra. Some fractures may collapse acutely while others collapse progressively over time (Fig. 1).(19)

If left untreated, spinal deformity can lead to subsequent fractures, often resulting in kyphosis (Fig. 2, above).(17) Kyphosis compresses the chest and abdominal cavity with the following potential consequences:

• Chronic, debilitating pain (6,24)
• Decreased lung function (VC, FEV1) (23)
• Impaired physical function (24)
• Early satiety and risk of malnutrition due to a compressed abdomen (24)
• Sleep disorders (24)
• Significantly decreased Activities of Daily Living (ADL) (6,24)
• Increased dependence on family members and friends (6)
• Clinical anxiety and/or depression (6,24)
• A 23% increase in mortality rate (10)

Detection of a VCF
Because of the complex etiology of back pain, approximately two thirds of these fractures go undiagnosed or untreated, in part due to diffculty determining the cause of symptoms. Lyritis et al. showed that 42 percent of 210 consecutive patients with symptomatic VCFs did not show collapse on initial x-ray (see Fig. 1 below and Fig. 3 on following page).(19) However, as reported by Drs. Gold and Silverman, in light of the growing evidence that vertebral fractures can significantly increase morbidity and mortality over time, it is important to diagnose vertebral fractures, to understand the value of lateral spine radiographs, and to consider ordering additional radiographs if initial films do not show fracture.(7)

Vertebral Fracture Progression (Fig. 1)
T-12 Vertebral Compression Fracture

MRI images of progressive morphometric changes
in the presence of a vertebral compression fracture
at T-12 (the thoracolumbar junctions).

January 2003
Courtesy of Michael Hisey, MD, Texas Back Insititute

February 2003
Courtesy of Michael Hisey, MD, Texas Back Insititute

May 2003
Courtesy of Michael Hisey, MD, Texas Back Insititute

KyphX® Inflatable Bone Tamps are intended to be used as conventional bone tamps for the reduction of fractures and/or creation of a void in cancellous bone in the spine (including use during balloon kyphoplasty with KyphX® HV-R™ Bone Cement), hand, tibia, radius and calcaneus. KyphX® HV-R™ Bone Cement is indicated for the treatment of pathological fractures of the vertebral body due to osteoporosis, cancer, or benign lesions using a balloon kyphoplasty procedure. Cancer includes multiple myeloma and metastatic lesions, including those arising from breast or lung cancer, or lymphoma. Benign lesions include hemangioma and giant cell tumor. Kyphon is a registered trademark and HV-R and Ahead of the Curve are trademarks of Kyphon Inc. © 2004 Kyphon Inc. All rights reserved. 16000320-03

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www.kyphon.com
Phone: 877-459-7466
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email: customerservice@kyphon.com

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.