New Treatment Available for Painful Osteoporosis Spine Fractures

October 4, 2001

For six weeks, Wilma A. Tedder of Sparta was in almost "unbearable" pain after a bone in her spine fractured from osteoporosis, or brittle-bone disease.

"My husband had to do practically all of the housework," says Tedder, 67. "I cooked our meals, but by the time I had it ready I didn''t feel like eating the pain was so severe."

Then, Tedder learned about a new treatment to inject a cement-like substance into the collapsed bone to stabilize it and prevent pain. Called vertebropasty, the procedure was developed in France and has been offered in the United States for about five years.

"For many patients, the results are dramatic," said Pearse Morris, M.D., a specialist in interventional neuroradiology at Wake Forest University Baptist Medical Center who treated Tedder. "Studies suggest that 75 percent to 90 percent of patients get relief from their pain."

Tedder said her pain was much better the day after the procedure and continued to improve during the next few weeks.

"There is no pain there now," says Tedder, who had the procedure in July. "I would never have thought it could be cured so fast."

In the past, there were few options for treating the fractures, which occur in about 16 percent of women over age 50. Doctors relied on pain medicine, braces, or prolonged bed rest, which can lead to pneumonia and blood clots in the legs in some patients. Even after these treatments, about one-third to 40 percent of patients still have chronic pain.

"This is a totally new option," says Morris. "Patients are eager to try it."

There are about 700,000 fractures of the vertebrae, or bones in the spine, each year.

As osteoporosis weakens the bones, even simple movements can cause fractures.

"Even turning ''funny'' while sitting can cause a fracture," said Morris. "It often takes only a mild trauma."

Spinal fractures are known as compression fractures because the vertebrae literally begin to collapse. Initially, the fractured bone retains most of its original height, but over the following weeks it can further collapse until only 10 percent of the original height remains. A succession of compression fractures is what causes the height loss and "humped" back that are common with osteoporosis.

"Think of the vertebrae as building blocks that support the spine," said Morris. "With these fractures, the bones can become almost pancake-like in size and the spine begins to curve."

Morris said vertebroplasty is most successful when the fractured bone still has one-third or more of its original height. Doctors also believe it is best to treat recent fractures - those that are less than a year old.

Vertebroplasty is an outpatient procedure that takes about an hour. Afterwards, patients lie still for about 4 hours while the bone cement hardens, and can then go home. In addition to treating osteoporosis fractures, vertebroplasty can be used to treat fragile bones from prolonged use of steroids for treating diseases such as lupus, asthma and rheumatoid arthritis.


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