Vertebral Osteoporosis and Kyphoplasty

Osteoporosis is a skeletal disorder, characterized by compromised bone strength from loss of bone mass. This disease effects up to 28 million people in the United States. Each year 1.5 million fractures occur due to osteoporosis. Approximately half of these fractures occur in the spine. One vertebral compression fracture occurs every 45 seconds.

About 260,000 patients are diagnosed with their first painful vertebral compression fracture every year and the risk of developing another fracture following the first increases five-fold. These fractures account for 150,000 hospitalizations every year. Fractures of the spine secondary to osteoporosis negatively affect pulmonary function. The five-year mortality rate following a vertebral fracture is significantly higher than in patients without fracture.

The goal of fracture care should be to restore anatomy, relieve pain and restore function as rapidly as possible. The care of fractures in the elderly is complicated by multiple medical comorbidities and frail physical status overall. Medical management can be successful but at the cost of prolonged disability, which negatively affects physical function and exacerbates additional bone loss. Open surgical treatment is generally reserved for patients with significant neurological deficits and has a high complication rate.

Minimally invasive, percutaneous fractures stabilization has emerged as a highly successful, and safe method for treatment of painful vertebral compression fractures. Under a light general anaesthetic, in the course of approximately a 45-minute procedure, the fracture is internally stabilized with acrylic bone cement. Pain relief is practically instantaneous and most patients can be discharged from hospital the following day. Post-procedure rehabilitation came commence immediately without limitations.

A patient's pain medication requirements are significantly reduced and they can return to their normal activities as soon as possible. Through a new modification of the technique, kyphoplasty, the fracture is reduced into a more anatomic position using an inflatable balloon. This prevents the development of the typical fracture kyphosis and allows for a safer cement injection to reduce the risk of complications.

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