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Balloon kyphoplasty procedures for treating spinal compression fractures can reduce pain and reliance on painkillers, according to researchers from the Department of Neurosurgery at the University of Alabama, Birmingham.


The Pain of Spinal Compression Fractures

Spinal compression fractures occur when a vertebra collapses upon itself. These fractures typically develop in the middle or lower back and occur most often in people with osteoporosis. Other causes of these fractures include cancer or traumatic injury.

Individuals with spinal compression fractures experience pain in the area of the fracture, but may also have pain in the hips, stomach or thighs. If left untreated, the pain of spinal compression fractures may become unbearable and severely limit the movement and mobility of sufferers.

The pain of these fractures develops because they cause the spine to pitch forward and press on the spinal cord. Over time, this pressure can also lead to numbness, tingling and loss of use of extremities.

Some spinal compression fractures that cause a severe forward pitch can also compress the nerves that control autonomic body functions like urination and defecation, leaving patients at risk of becoming incontinent.

"Spinal compression fractures can quickly make everyday activities like walking, using the stairs and bending over to pick something up excruciating," said Dr. Michael Budler. Budler is an interventional radiologist who performs the balloon kyphoplasty procedure on spinal compression patients in Grand Island, Nebraska.

Over time, these fractures can make sitting or laying down painful, too.

Conventional medical treatment for spinal compression fractures involves prescription pain medications and bracing the back for up to three months while the fractured vertebra heals.

This treatment often means living with pain for extended periods of time and may cause patients to reach for both over-the-counter and prescription painkillers more frequently.

"Relying on opioid painkillers to get through the day has serious consequences, like liver damage and addiction," Budler said.

Changing Outcomes with Kyphoplasty

The UAB study evaluated 350 people who had undergone kyphoplasty for their spinal compression fractures. Osteoporosis was the cause of 343 of the fractures, and the remaining were attributed to cancer.

Patients in the study reported an average pain rating of an 8.7 on a scale of 1 to 10, and a 63.4 rating on the Owestry Disability Index, a tool used to determine functional disability of patients with back problems.

Researchers looked at the reported outcomes one, three, six and 12 months after the procedure and found the average pain rating of study participants decreased over time, going down to 2.4 after a year.

Reduction in pain also meant a decrease in the use of opioid pain relievers.

Patients also reported improvements in mobility and activity, lowering the average disability rating to 27.2 after one year.

The kyphoplasty procedure is a minimally invasive treatment designed to lift the compressed vertebra back to its natural height.

During the kyphoplasty procedure, Budler numbs the area near the fracture site. Once numbed, he makes a small incision and inserts a thin catheter tube. Through the tube, he pushes a small balloon.

Once the balloon is in place, Budler slowly inflates it, creating a space and pushing the vertebra back to its natural position.

In the space, Budler injects a mixture of bone cement and a unique polymer designed to facilitate bone growth. This combination hardens quickly, strengthening the collapsed vertebra.

The reinforced vertebra allows the patient to stand up fully once again, relieving pain and pressure on the spinal cord.

"Patients who could not walk or sit without being in intense pain see a tremendous reduction in discomfort almost immediately after the kyphoplasty procedure," Budler said.

 

Source: 

Medscape. Kyphoplasty for Vertebral Fractures Reduces Pain, Opioid Use. Medscape. 11 May 2017.