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New Treatment Relieves Pain from Compression Fractures

Compression fractures of the spine are a common ailment. They affect about one in four post-menopausal women whose bones are often weakened by osteoporosis. The fractures are often caused by falls but can happen during ordinary activities around the house like opening a stuck window or bending to lift a heavy package. If osteoporosis is severe, even a cough, sneeze or bump could cause a vertebra to crack.

The vertebral body is the round donut-shaped part of the vertebra. The compression fracture typically causes the front part of the vertebral body to crumple so that the spine angles slightly forward. The injury can cause severe pain that is localized in one spot, but compression fractures also can progress gradually causing minor symptoms that may be dismissed as general back pain, muscle strain or a natural part of aging.

“It is important to diagnose and treat vertebral compression fractures because after an initial fracture, the risk of a second one increases five times,” noted Lotfi Hacein-Bey, MD, director of neuroradiology and interventional neuroradiology at Loyola University Health System (LUHS).

The fractures are most common in older women, but also can occur in men and in people of any age. A significant number are associated with cancers including multiple myeloma, lymphoma, leukemia and metastatic breast, lung and prostate cancer.

Over time, multiple vertebral compression fractures cause chronic pain, a stooped posture and other complications. “Studies have shown that people with multiple compression fractures often are depressed and anxious due to the chronic pain and restrictions of their activities. In addition, the forward curvature of the spine puts pressure on organs making it difficult for people to breathe, walk, eat or sleep properly,” said Dr. Hacein-Bey.

Traditional treatments have included bed rest, back bracing, physical therapy and pain medication. These treatments can sometimes alleviate pain, but usually do not prevent the gradual deterioration of the patient’s health.

On the other hand, a newer treatment, called balloon kyphoplasty, has proven extremely successful in relieving pain, stabilizing the spine and restoring vertebral height. The procedure was approved in the late 1990s by the U.S. Food and Drug Administration and has grown in popularity in recent years. Dr. Hacein-Bey is one of a handful of interventional neuroradiologists in the Chicago area who has expertise in balloon kyphoplasty. He has performed more than 300 of the procedures.

Balloon kyphoplasty is a minimally invasive treatment that requires only very small incisions and usually takes less than an hour per fracture. A small, hollow instrument is used to create an opening in the fractured bone. A balloon is guided through the instrument into the vertebra and inflated to raise the collapsed bone. Once the vertebra is restored to its normal height, the balloon is removed and special cement is used to fill the cavity and solidify the bone. Most people can stand and walk with minimal pain immediately after the procedure and are able to go home the same day.

Last year in the Journal of Palliative Medicine, Dr. Hacein-Bey and his colleagues reported that balloon kyphoplasty eliminates pain in 90 percent of patients with compression fractures. “This treatment has made a huge difference in the lives of many people,” he said.

To make an appointment with an interventional neuroradiologist at LUHS, call (888) LUHS-888.