Because broken bones due to osteoporosis, the progressive loss
of bone tissue, are very common and may be very painful, a new way
of treating these fractures called vertebroplasty is real medical
Normal bone is composed of a framework made of a particular protein,
collagen, and calcium salts. Osteoporosis depletes both the collagen
and the calcium salts from the bone. The bone then becomes weaker
and more prone to breaks (fractures), either by cracking or by collapsing
Patients with osteoporosis generally have no symptoms until the
bone fractures begin. Fractures of the bony building blocks (vertebrae)
of the spine are usually a result of the compression of bone. This
leads to collapse of the vertebrae much like a sponge collapsing
under the pressure of one's hand. A fracture that collapses a vertebra
in this way is referred to as a vertebral compression fracture.
Spinal vertebral fractures can occur without pain. However, they
often cause a severe "band-like" pain that radiates from the spine
around both sides of the body. Over many years, the spinal fractures
cause a loss of height of the spine resulting in the person becoming
shorter. A curvature of the spine can also occur giving the individual
a hunched-back appearance (the so-called dowager's hump). This can
lead to chronic backaches.
The treatment of vertebral compression fractures has been limited
to taking pain medicine, resting, avoiding injury, and bracing.
A new procedure to treat new vertebral compression fractures, first
developed in France, is being pioneered in the United States by
Dr. Mary E. Jensen at the University of Virginia. The technique
is called vertebroplasty and is performed by a radiologist without
Vertebroplasty 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 locally broken bone.
At a conference in Irvine, California, Dr. Jensen said that relief
of pain may come from a casting effect on the broken bone. The newly
hardened vertebra may then be protected from further collapse.
Vertebroplasty can relieve pain extremely fast, even within a day
in some patients! Dr. Jensen described patients being released from
requiring intravenous pain drugs.
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).
Dr. Jensen was asked if severely collapsed vertebrae wouldn't be
technically more difficult as well as less successful to treat.
She indicated that vertebrae that have collapsed to less than 30%
of their normal height were indeed poor candidates for this procedure
because of poor success rates.
She did point out that she had had success in treating more than
one vertebral compression fracture in the same patient!
Vertebroplasty appears to be an exciting 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 radiologists gain experience in the procedure.