Fragility fractures are a serious and growing problem for older adults and the healthcare system. In fact, 50% of women and 25% of men will have an osteoporotic fracture in their lifetime. Vertebral compression fractures (VCFs) are the most common with an estimated 700,000 such fractures reported nationally each year. The annual direct medical cost is estimated at $746 million.
Vertebroplasty offers a proven and safe treatment that assures the best quality results for your patients and the healthcare system. This minimally invasive, image-guided treatment, in which bone cement is injected into the vertebral body, significantly decreases pain and increases mobility in more then 90% of patients. The stabilizing of the fracture helps protect against further collapse of the treated vertebra, thereby preventing the kyphosis commonly seen as a result of osteoporosis.
Embolization is a minimally-invasive technique for blocking the abnormal vessels in an arteriovenous malformation or dural fistula. It is usually done in an attempt to eliminate or reduce the risks of hemorrhage associated with either an AVM or DAVF.
With AVM or DAVF embolization, an interventional neuroradiologist guides a long tube called a catheter through a small incision in the groin up to the location of the AVM or DAVF. Through the catheter, the radiologist injects various materials, called embolic agents, into the abnormal blood vessels to reduce blood flow or completely block them.
The spinal cord is an extension of the brain that is situated inside the spinal column (or backbone), which connects the nerves from the brain to the rest of the body. This enables the brain to control movements of limbs and internal organs, such as the urinary bladder or bowel, and also to receive sensory information such as pain or touch sensation from the limbs.
In both arteriovenous malformation (AVM) and dural arteriovenous fistula (DAVF), an abnormality occurs in the connection(s) between arteries and veins on or inside the spinal cord.
It is not known why these abnormalities happen or what causes them. It is believed some people are probably born (i.e. it is congenital or inherited) with a predisposition or tendency to form this abnormality and at some stage in life it develops. It is not known what triggers this.
Treatment consists of embolisation by itself or combined with open surgery. Embolisation is a "key hole" surgical technique (surgery through a small cut or incision) which enables the injection of medical grade "glue", special tiny coils, or sand like particles directly into the abnormal connection or 'site' to block off the abnormal blood vessel connection.
The procedure is performed through a tiny plastic tube placed into the blood vessels, using X-ray images or pictures to guide insertion of the tube to make sure it is in the right position before an AVM or DAVF is treated with the glue, particles, or coils.
Kyphoplasty is often discussed along with vertebroplasty, another procedure. These are used to treat fractures in the bones of the spine. These bones are vertebrae. During a vertebroplasty, the doctor injects a cementlike material into the bone to make it more stable. During a kyphoplasty, the doctor first inflates a balloonlike device in the bone to make space. The space is then filled with cement.
Reasons for the procedure
You may need a kyphoplasty if you have certain types of fractures, or broken areas, in your spine. In most cases, osteoporosis — or thinning of the bones — plays a role in these fractures. The fractures cause the bones to collapse or become compressed. The fractures can cause pain or lead you to develop a hunched-over posture.
The procedure may also be done if cancer has damaged a vertebra. A kyphoplasty may make the bone a little taller to help make up for the height it loses when it's compressed. The procedure may also relieve pain.
Usually doctors perform this procedure only after trying other treatments. These may include your wearing a back brace or taking pain medicine.
Risks of the procedure
The risks involved in a kyphoplasty include:
The amount of radiation used during an X-ray procedure is considered minimal; therefore, the risk for radiation exposure is low. But if you are pregnant or suspect that you may be pregnant, you should notify your health care provider.
There may be other risks, depending on your specific medical condition. Be sure to discuss any concerns with your doctor before the procedure.
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