Monday, April 26, 2010
Normal 0 false false false EN-US X-NONE X-NONE
Osteoporotic vertebral compression fractures can create a challenging state of chronic pain and disability. The challenge is for both the physician who is scratching his/her head and for the tearful man or woman who is ...
Hi Dr. Lasich, I'm very glad you wrote this article because you've touched on something I've always wondered. Where we live very few Drs will do vertebroplasty and opt for kyphoplasty instead. Would you say the same problems would occur with both procedures, since bone cement is used in each one?
I've also heard the vertebroplasty is used for old fractures and kyphoplasty is used for new/fresh fractures, would you concur? I realize these procedures aren't for everyone, but really wanted to know if they both pose the same risks, even though the procedure is somewhat different.
Thanks,
Pam
Thanks Pam for bringing up the second half of this story--Kyphoplasty.
Kyphoplasty, a much newer technique, offers a more costly and complicated procedure with potentially better outcomes than seen with vertebroplasties. The first large study of kyphoplasties was preformed between 1998 and 2000 with 1439 patients. The results were promising, a 90% success rate with a 0.2% complication rate. Cement leakage is less likely due to the space created by the bone “jack” (remember, vertebroplasty does not use a “jack”) allowing for placement of thicker cement that is less likely to leak. Pain relief is achieved by restoring the shape of the bone and correction of the misalignment. Is this the best option?
Vertebroplasty or Kyphoplasty… If I were guiding you in this decision, I would ask myself, “What if you were my mother?” That’s right, what would I choose for my own mother? Hands down, Kyphoplasty wins. This procedure has a better chance at correcting the misalignment, has less potential for leaking cement, and has great results. Both procedures are risky. Let’s face it. Anytime a needle gets shoved into the spine, disaster can strike. I am usually most worried about infection when it comes to needles.
Over the long run, I doubt that Kyphoplasty is any more successful than conservative treatment, like seen from the results of this recent comparison of Vertebroplasty to conservative treatment. Although, I have not seen an actual study comparing Kyphoplasty to conservative treatment in a randomized, long term study. However, I do believe that these procedures are not for everybody and should be reserved for those who fail or cannot tolerate conservative treatment.
Dr. Christina Lasich, MD