Despite dramatic advances in nutrition and physical fitness, osteoporosis, which is low bone density, has millions of older Americans justifiably concerned about the health consequences of accidental falls. According to the American Association of Neurological Surgeons (AANS), an estimated 10 million Americans have osteoporosis, and an additional 34 million are estimated to have low bone mass, which an early stage of osteoporosis. Of the 10 million Americans with osteoporosis, the association estimates eight million women and two million men have this condition.
While the cause of these concerns is osteoporosis, the very dangerous effect of this condition is often spinal compression fractures, which affect about 750,000 people annually. The AANS estimates that these spinal fractures affect an estimated 25 percent of all postmenopausal women in the U.S. The organization noted, “The prevalence of this condition steadily increases as people age, with an estimated 40 percent of women age 80 and older affected. Although far more common in women, spinal compression fractures are also a major health concern for older men.”
To make this problematic medical condition even more challenging, patients who have sustained one osteoporotic fracture are more likely to sustain a second spinal compression fracture, according to the AANS.
Medical science has taken notice of the prevalence and severity of these spinal compression fractures and developed innovative surgical remedies. One of these is a procedure known as kyphoplasty, and it is performed by the spine specialists at Texas Back Institute, including Dr. Michael Hisey.
“The primary cause of spinal compression fractures is osteoporosis,” Dr. Hisey noted in a recent interview. “However, they could also result from a tumor, which softens the bone and makes it weaker.”
According to Spine Health, a digital publication, “Compression fractures typically occur in the thoracic region of the spine, which includes the T1 through T12 vertebrae, but may also occur in the lumbar spine, or L1 through L5.”
Dr. Hisey noted, “When the fracture occurs, the vertebra is compressed like a piece of Styrofoam, resulting in pain and potential long-term damage to the nerves and spinal cord.”
A Minimally Invasion Procedure
Dr. Hisey is an expert in the use of kyphoplasty to correct these types of spinal fractures and he has found it to be very effective. In fact, on Mother’s Day Weekend of 2017, he performed four of these procedures!
“This is a minimally invasive procedure that results in less surgical trauma,” Dr. Hisey said. “The goals of kyphoplasty are to reduce pain from the fracture, stabilize the vertebra and restore the vertebra back to its normal height. The procedure involves introducing a small balloon through a 3mm tube, into the fractured bone. This balloon is then inflated, pushing the fracture into its correct position. This leaves a hole in the bone the size of the balloon. We then fill this hole with medical cement known as PMMA.
“The surgeon is viewing and managing this process by means of a real-time, x-ray image and the tiny incision – about 1/8 of an inch – in the patient’s back.”
“The greatest advantage of kyphoplasty over other surgical procedures is its ability to lift the fracture up,” Dr. Hisey noted. “Plus, the patient gets almost immediate pain relief. After kyphoplasty, we have noticed that patients get better very quickly and predictably. Rapid recovery time is also an advantage of this procedure. The cement is about 98 percent hardened within twenty minutes after we apply it, and the patient is able to move around almost immediately after surgery.”
Surgery is always the final option for the spine specialists at Texas Back Institute because there is always a risk of complications. Kyphoplasty has several risks.
“It is surgery and any time we have a patient with osteoporosis there is the potential for anesthetic complications. Complications from the procedure itself could also occur. When the balloon is introduced into the bone there is always the potential for irritating the nerves or the spinal cord. However, this is very uncommon.
“The most common risk of a kyphoplasty involves the cement leaking out of the bone and going to another area of the body. In most cases, this does not present a problem but if it happens to come into contact with a nerve, we have to remove it immediately.”
What About Future Fractures?
While Kyphoplasty has proven to be an excellent procedure for repairing compressed spinal fractures, a patient who suffers from osteoporosis is at a higher risk for future fractures with other bones.
“By presenting with this type of fracture, the patient has shown that their bones are softened to the degree that other fractures are likely,” Dr. Hisey noted. “If a patient has had a spinal fracture, they are four times more likely to have another one and if they experience a second fracture, they are seven times more likely to have another.”