18Apr 2017

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IS IT FOR YOU?
If you have back pain and are found to have a vertebral compression fracture, that is, a break or collapse of the vertebral bones, the minimally invasive procedure known as Kyphoplasty may be recommended as a treatment option for you. According to one of our pain specialists, Dr. Kenneth Chapman, “If you can grin and bear it, then that is the first option. The least invasive option is always the best route. What needs to be considered is to what degree the pain causes disability. An inability to function normally can lead to loss of muscle mass, deep vein thrombosis, weight loss, depression and can lead to falls, which can lead to further fractures. The risk of developing these secondary effects of pain and disability far outweighs the risks of the Kyphoplasty procedure.” The pain from a vertebral compression fracture can range from mild, and can be confused with a simple backache, to severe and debilitating, leading to hospitalizations resulting from the pain. Pain from a broken bone in the spine can heal. Time, rest, anti-inflammatory medications (Ibuprofen, Alleve, Naprosyn), opioids medications, and sometimes a brace are the first line treatments for a fracture. However, when the pain is too severe, the disability from the pain is too limiting, or a patient’s improvement is not moving quickly enough, there may be a need for an intervention.

HOW DID WE GET HERE?
Vertebral compression fractures can occur for several reasons. Something so trivial as lifting a laundry basket or opening a window may be the culprit. Or, it may result from a traumatic event such as a fall. Most commonly, however, it occurs as a consequence of Osteoporosis, which is the loss or decrease of the mineral constituents of the bones. These bones are thus ‘softened’. Weakened bones are the primary cause of painful fractures. When a compression fracture occurs, it may involve the collapse of one or more vertebrae in the spine that results in pain, hunched back, loss of height, numbness, tingling, weakness, incontinence, and other unpleasant symptoms that may vary from patient to patient. Kyphoplasty is designed to relieve the pain, to stabilize the bone, and to restore lost mobility. An important portion of the procedure is taking a biopsy of the collapsed bone. This assures us the fracture is from Osteoporosis and not other possible causes of bone weakness. “More often than we would like, we find other causes of compression fractures like multiple myeloma or a metastatic cancer. A compression fracture can be a presenting symptom in these diseases — and it’s our job to find that,” says Dr. Chapman.

HOW IT’S DONE
kyphoplasty-spine-surgery-2The kyphoplasty procedure is performed through trochars (larger needles) with the patient awake or sedated. One of the benefits of our specialists performing this procedure is that you do not need general anesthesia, which most Kyphoplasty that an orthopedic or neurosurgeons perform require. “Avoiding general anesthesia is one of the biggest benefits of us performing the procedure. We, as pain specialists, are used to patients being awake and talking during the procedure. Surgeons tend not to be used to that. The risk of a general anesthetic can outweigh the benefits of the procedure in this compromised, often elderly population” adds Dr. Chapman. Be sure to see a specialist regarding the severity of your back pain. It is also important that if you are not getting treatment for Osteoporosis, that you should see a specialist for an evaluation. “It’s never too late to change your lifestyle and/or potentially start treatments for the condition,” according to the doctor. If you or a loved one are found to have a compression fracture and have pain you can consult one of our physicians to determine if Kyphoplasty is right for you. The board-certified pain specialists at The Spine & Pain Institute of New York are regarded as experts in the field and are available for consult and more information on Kyphoplasty and related procedures.