Lancaster Physician Fall 2019 - 11

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We have many more options today to
help these patients. One of these options
is a minimally invasive surgical procedure
called kyphoplasty. With kyphoplasty, the
surgeon basically puts a needle into the bone
that is broken and glues the pieces together
so that they are no longer painful.

Understanding Compression Fractures
A compression fracture occurs when
a spinal bone fractures and collapses (or
compresses). The fractures typically occur
in the thoracic region of the spine, which
includes the T1 through T12 vertebrae, but
they may also occur in the lumbar spine, L1
through L5. Fractures may happen as the
result of an accident or injury, but in most
cases they occur without any obvious injury,
often as a result of osteoporosis, a condition
that causes bones to become brittle.

The warning
signs of a
compression
fracture
include:
* Increasing pain in the back,
legs, and/or arms
* A decrease in height
* The inability to bend and twist
* Numbness or tingling in the
arms or legs
If the fracture is the result of an injury,
the patient could feel sudden, disabling pain.
Most often, though, compression fractures
occur in spines weakened by osteoporosis.
Osteoporosis is most common in elderly
women, making them more likely to suffer
compression fractures.

Compression Fracture Treatments
Patients with compression fractures related
to osteoporosis will need to be treated with
bone-strengthening medicine, calcium, and
vitamin D supplements. Physical therapy
and exercises may be recommended, too.
Together, these will help make the bones
stronger and can help prevent other fractures.
In most cases, compression fractures will
heal on their own, and that is our preferred
treatment. People usually suffer for a week
or two, and then they start doing better.

This treatment often includes:
* Medicine to relieve the pain
* Bed rest for a short time, followed by
limited activity while the bones heal
* Wearing a back brace
* Physical therapy to help the patient
move better and strengthen the muscles
around the spine
If patients continue to have pain for six
weeks and don't seem to be getting better,
they may be candidates for kyphoplasty. The
overall success rate of kyphoplasty is about
85 percent, so it doesn't work for everyone,
nor do we recommend it for everyone. We
carefully evaluate patients to ensure that
kyphoplasty is likely to reduce their pain.

How Kyphoplasty Is Performed
Kyphoplasty is a minimally invasive procedure. The goals are to reduce pain from the
fracture, stabilize the vertebra, and restore
the vertebra back to its normal height.
The surgeon may numb the area, or
patients may get anesthesia to put them
asleep. The doctor makes a small cut in the
back and puts a balloon device into the
fractured vertebra to create an open cavity
inside the bone and restore height to the
collapsed vertebra.
The surgeon then injects a special bone
cement into the cavity until it is full. The
cement hardens quickly, creating an internal
cast inside of the fractured vertebra.

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PHYSICIAN

The procedure takes one to two hours to
treat each vertebra. Most patients go home
the same day.

If Spine Surgery Is Needed
Surgery is usually a last resort. However,
when patients' spine conditions require
surgical intervention, it's important that
they go to board-certified, fellowship-trained
neurosurgeons, spine surgeons, and orthopaedic surgeons with extensive experience.
It's also important that patients have
access to a full range of care to guide them
through the entire process from preparations
to surgery and through recovery. This team
should include:
* Surgical specialists
* Nonsurgical spine specialists
* Rehab specialists, such as physiatrists,
physical therapists and occupational
therapists
* Pain management specialists
* Specially trained operating room staff
* Nurse navigators
Kyphoplasty is not for everyone, but for
the right patient, this technique can help
stop the debilitating pain of a compression
fracture.



Lancaster Physician Fall 2019

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