New Hope for Sufferers of Vertebral Compression Fractures Caused by Osteoporosis
OUTPATIENT PROCEDURE
by Elizabeth Pigetto-Rivera, Reporter, Fox News ( Monterey , California )
As we get older, our hair isn't the only thing thinning. Our bones are as well, and that can lead to far more serious problems than hair on the pillow.
Osteoporosis affects more than 44 million Americans a year and 80-percent of people living with the debilitating disease are women. Doctors at American Academy of Orthopedic Surgeons say menopausal-age women have a 16 percent chance of sustaining an osteoporodic fracture by the time they're 50.
The widespread disease thins out the bones making them weak and brittle which leads to increased fractures typically of the hip, spine and wrist.
A study featured in the December 2004 issue of The Journal of Bone & Joint Surgery reports if osteoporosis has developed, treatment is important to prevent debilitating vertebrae and hip fractures.
"It can cause musculoskeletal pain, deformity, disability and even death," says Fergus McKiernan , MD , one of the study's authors and director of the Center for Bone Diseases at the Marshfield Clinic in Marshfield , Wisconsin . "More than likely these groups of patients have a 20-percent risk of developing a second fracture within a year if they are not treated right away,"
Besides the general prevention strategy of maintaining an adequate calcium intake, like eating calcium rich foods, remaining physically active, and avoiding lifestyle factors, particularly smoking, there are other treatments back pain suffers can take to build and maintain strong bones, to a certain degree.
Treatment Alternatives
Most patients attempt to treat back pain with bed rest. But Huy Do, M.D, an interventional neuro-radiologist and professor of Radiology and Neurosurgery at Stanford University Medical Center , suggests less and less of this formality because of the risk of deconditioning (or losing fitness) .
"We now know that a shorter period of time, such as two to three days followed by a guided physical therapy program is a better solution to back pain,'' says Dr. Do. "But if it goes on for a couple of weeks than you lose muscle tone which delays recovery."
Many doctors will also prescribe medications to prevent bone loss and help reduce inflammation, muscle spasms and pain.
According to The Lancet and The Journal of American Medical Association (JAMA) -- studies suggesting that the class of cholesterol-lowering drugs called statins may also cut the risk of fractures by half.
Felicia Cosman, M.D., clinical director of the National Osteoporosis Foundation says that older women are at risk for both heart disease and osteoporosis, so a single pill that could treat both conditions would be a major breakthrough.
But some doctors say taking certain "anti- resorption drugs, like Calcitonin and Alendronate may decrease the rate at which osteoclasts reabsorb bone.
"Those are complimentary medicine that can help along, but the pain is due to the fracture, not the healing, "says Dr. Do.
Some patients have complained these drugs can also upset stomachs and cause swelling in the legs. [Also the patient can reach a plateau where the drug no longer works-that is when other methods of treating the pain from Vertebral Compression Fractures become very important.]
When it comes to using a spine brace the treatment is intended for low back pain users associated with degenerative disc disorders, trauma or postural deformities. By immobilizing the spine by using a spinal brace it would control back pain by limiting motion and unloading discs, vertebrae and other spinal structures by compressing the abdomen. However, some doctors feel the custom fitted flexible braces or corsets are a temporary fix.
"It's not helpful. A lot of patients find them to be uncomfortable because they tend to be thin and rub against their skin and cause infection," says Dr. Do.
That's why many doctors are turning to medical device companies like ArthroCare Spine who offer tools for Percuntaneous Vertebroplasty, a non-invasive procedure performed by specialists like Dr. Do.
"With imagining guidance neuro-radiologists would insert a small needle into the bone and inject this acrylic cement through a small hole in the skin. The cement than stabilizes the fracture, which stops the pain and prevents the bone from collapsing and causing further damage," says Dr. Do.
Since the Federal Drug Administration approved the French-born procedure five years ago, doctors are able to treat thousands of vertebral compression fractures without needing general anesthesia, just sedative and local numbing. That's good news for older adults.
"If you're over 70 some patients wouldn't want to go under anesthesia, it's considered high risk," says Dr. McKiernan. "Over the years we've shied away from operations with older adults because their bones are poor quality. We've had our hands tied until now."
"Up into ten years ago main therapy was "conservative treatment" bed rest, medicine, brace if they can bear it,'' says Dr. Do, "but now a procedure like vertebroplasty is like going to the dentist. You're in and out in a couple of hours."
But for some patients it's not so much the length of the procedure that they care about as opposed to having the procedure treat their pain quickly.
Shirley Cooper from Fresno , California suffered two fracture vertebrates and was practically bed ridden because the pain was so great.
"The word I would use to describe the pain was excruciating. I was taking pain medication, but it didn't really help. I was in a lot of pain."
At age 83, Cooper was worried she wouldn't be able to continue playing golf or go walking with her friends. "I knew I had to do something and do it quick, so my doctor recommended I try vertebroplasty ."
This past November Cooper had the procedure done at Stanford Medical Center . She described the treatment as being "quick, easy and the pain relief immediate."
"The procedure was done in a matter of an hour. Entirely painless, they numb the particular area, inserted the needle into the fracture vertebrate and a few hours later I was home. Within a couple of hours I was home walking around my kitchen."
Now Cooper advises all her friends who suffer from back pain to look into the treatment.
"I have not hesitated to tell them about the procedure. I tell them they can either live with the pain or take this procedure. And it must be working because they are all surprised to see me out and about so quickly."
Dr. McKiernan hopes word of mouth and continued studies will convince other patients and surgeons to perform vertebroplasty, paired with a comprehensive osteoporosis care program.
"The more doctors who use this procedure the more people we can help in the long run,'' says Dr. McKiernan. "Followed by post treatment like making sure the patient sees a bone specialist and a physical therapist will become the treatment of choice for everyone in the coming year."
For more information about vertebroplasty , please visit www.vertebroplasty.com
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