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Osteoporosis and Vertebral Compression Fractures
Osteoporosis occurs when there is inadequate mineralization of bones, leading to bone weakening and potentially fractures. This disease is very prevalent in the US, affecting older individuals of both sexes. Osteoporosis can be treated medically with drugs that promote bone formation. Despite proper medical treatment, patients with osteoporosis may suffer vertebral compression fractures. These fractures may occur after trivial injures or even while doing normal activities of daily living. Up to 25% of post-menopausal women and 40% of women older than 80 years suffer from osteoporotic vertebral fractures. Once a fracture occurs, the spine may become misaligned, causing the spinal nerves to become compressed and leading to severe back pain. The initial treatment is with pain medication. However, a significant number of patients continue to have severe pain and disability.
This is a minimally invasive procedure in which a special needle is placed through a small incision in the skin into the fractured vertebra. The placement of the needle is performed under imaging guidance. Once the needle is in the vertebra, the physician may choose to temporarily inflate a balloon within the vertebra. This is done to create a cavity for bone cement injection and to restore some height to the compressed vertebral body. Bone cement is then injected until the broken bone is adequately filled and the fracture is stabilized. This procedure can be performed with intravenous sedation or general anesthesia. Patients are discharged a few hours after the procedure. Significant decrease or complete relief of pain is seen in 85-95% of patients treated.