Vertebroplasty

A new nonsurgical method for the repair of osteoporosis back fractures. Broken bones in the spine are often due to osteoporosis, the progressive loss of bone tissue, which depletes both the collagen and the calcium salts from bone so the bone then becomes weaker and more prone to breaks (fractures) by cracking or by collapsing (compression). People with osteoporosis rarely have symptoms until the bone fractures occur. When this results in compression of bony building blocks of the spine (vertebrae) it can collapse the vertebrae much like a sponge collapses under the pressure of one’s hand. A fracture that collapses a spinal vertebra in this way called a vertebral compression fracture. Although they may occur without pain, vertebral fractures often cause a severe “band-like” pain that radiates from the spine around both sides of the body. Over many years, spinal fractures lessen the height of the spine and the person becomes shorter. The treatment of vertebral compression fractures has been limited to taking pain medicine, resting, avoiding injury, and bracing. Vertebroplasty, a procedure to treat new vertebral compression fractures, was first developed in France and is being pioneered in the U.S. by Dr. Mary E. Jensen at the University of Virginia. The technique is performed by a radiologist without surgery and involves inserting a glue-like material into the center of the collapsed spinal vertebra in order to stabilize and strengthen the crushed bone. The glue (methylmethacrylate) is inserted with a needle and syringe through anesthetized skin into the midportion of the vertebra under the guidance of specialized x-ray equipment. Once inserted, the glue soon hardens, forming a cast-like structure with the broken bone. Relief of pain comes quickly from a casting effect on the broken bone and the newly hardened vertebra are then protected from further collapse. The advantages of vertebroplasty, aside from prompt pain relief, include better mobility. (Often patients with new vertebral fractures can’t even sit up without worsening the severe pain and the inactivity contributes to further osteoporosis). Vertebrae that have collapsed to less than 30% of their normal height are poor candidates for this procedure. Vertebroplasty appears to be an exciting new option for urgent control of pain from vertebral compression fracture. While only just being introduced in the United States, it will likely become more widely used as doctors gain experience in the procedure. Kyphoplasty is a recently developed term for the vertebroplasty procedure. Frankly, vertebroplasty is more accurate. Kyphosis means the bending of the spine to curve outward from the body. Kyphosis can result when a vertebra (or several vertebrae) suffers a compression fracture from osteoporosis (This is the classic humped posture of an elderly senior with severe osteoporosis). Plasty means to repair. Vertebroplasty is the procedure that can re-establish the height of a compressed vertebra. Sometimes (not always) this can correct some of the kyphosis. Perhaps more as a marketing angle, vertebroplasty has thus also been referred to as kyphoplasty. Sometimes vertebroplasty has been performed using an inflatable balloon to initially "reinflate" the collapsed vertebra prior to insertion the methylmethacrylate glue.

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ver·te·bro·plas·ty 'vər-tə-brō-.plas-tē n, pl -ties a medical procedure for reducing pain caused by a vertebral compression fracture (as that associated with osteoporosis) that involves injection of an acrylic cement (as methyl methacrylate) into the body of the fractured vertebra for stabilization compare kyphoplasty

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ver·te·bro·plas·ty (vurґtə-bro-plas″te) [vertebro- + -plasty] plastic repair of a vertebra. vertebroplastic adj