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Balloon Kyphoplasty - For all spinal fractures are caused by osteoporosis
“Balloon Kyphoplasty -- ,is proving to be a suited option to
treat vertebral compression fractures (VCFs) that occur as a
complication of osteoporosis, cancer or trauma”, says Dr. Rajesh
Jain, Sr. Consultant – Neurosurgery, Modern Medical Institute
( MMI ), Raipur.
83 percent of all spinal fractures are caused by
osteoporosis
Raipur, 20th October, 2010: Recently, Dr Rajesh Jain, Sr. Consultant- Neurosurgey, MMI, performed the first Balloon Kyphoplasty procedure. This new minimally-invasive orthopaedic spine
procedure -- Balloon Kyphoplasty -- is proving to be a suited option to treat vertebral compression
fractures (VCFs) that occur as a complication of osteoporosis, cancer or trauma. Now available at
select Indian hospitals, Balloon Kyphoplasty is gaining popularity as a new therapeutic option that
offers an effective treatment to fix spine injuries with negligibly low complication rate. |
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Dr Rajesh Jain, Sr. Consultant- Neurosurgey, MMI, said “Balloon Kyphoplasty essentially makes
use of two orthopaedic balloons, inserted through 1 cm incisions. The balloons are gently inflated
inside the fractured vertebrae to gently raise the patient’s collapsed vertebrae to its pre-fractured
height, creating a void inside the vertebral body. After deflating and removing the balloons, the
void is filled with viscous bone cement in a controlled manner under low manual pressure. Like
vertebroplasty, it is also performed under local anesthesia through a pin-hole approach and can be
a day care procedure“.
Dr Rajesh Jain further said “While both pin-hole procedures to correct VCFs result in symptomatic
relief, Balloon Kyphoplasty differs from Vertebroplasty in the sense that the tools used to perform
Kyphoplasty are specifically designed to achieve correction of fracture-related angular deformity
and restoration of the lost body height. However, Balloon Kyphoplasty can not always be used to
help every type of VCF. Only trained doctor can decide whether the Kyphoplasty procedure is right
for a patient or not.”
A recently published research has shown clear superiority of Kyphoplasty over Vertebroplasty.
The risk of subsequent fracture of the adjacent or non-adjacent verterbral body is greatly reduced
with Kyphoplasty. This is because Kyphoplasty, by correcting the deformity and restoring the
height, restores the normal bio-mechanics of the human spine. Kyphoplasty also helps inject higher
quantity of cement. The stability of the vertebral body is bettered with higher quantity of cement.
The procedure can also reduce the need for narcotic pain medication and the number of doctor
visits related to back pain/osteoporotic problems.
Latest medical advancements such as the master pin-hole Balloon Kyphoplasty ensure good
treatment options for VCFs. However, for best results and least complications, early screening and
appropriate medical management is vital.
Vertebral body compression fractures (VCFs) - fractures of weakened vertebral body resulting
from trivial trauma/loading during normal daily activities- are extremely common among patients
with osteoporosis. Of the many causes of osteoporosis, senile osteoporosis (due to older age) and
osteoporosis secondary to menopause (loss of hormonal support) constitutes largest groups of
patients suffering from osteoporosis. Most often these are patients presenting with VCFs whom we
commonly come across in our day to day practice.
In other words, VCFs are commonly found in older age group (above 60 years). Almost 25 percent
of females may suffer from VCFs between 60 to 80 years of age. Risk is doubled to 50 percent
beyond 80 years. VCFs are also found in young population with unaccustomed loading of spine,
and presents as acute traumatic compression fracture. In particular, vertebral fractures that occur
as a complication of osteoporosis or trauma has smaller impact on mortality but can lead to severe
chronic pain of neurogenic origin. Pain arising from such VCFs can be potentially debilitating and
this could be hard to control without medical help, besides leading to a possible deformity.
Diagnosis of a VCF at the very instance is the first step towards providing patients with hope for
treatment. The consequences of untreated spinal fractures can be devastating. Since in the case
of a VCF there may be slight reduction in swelling and pain a few days after the injury, patients
may want to overlook the severity of the problem. If left unattended, the risk of suffering a second
fracture increases five-fold, and could lead to further complications.
Medical management of VCFs consists of bed rest, bracing, anti-osteoporotic bone strengthening
medications etc. In elderly patients, such non-surgical treatment options carry the risk of multiple
complications, which may be potentially life threatening like stroke, lung complications, heart
complication, adjacent fractures etc. Moreover, it propagates the cascade that further weakens
the bone due to disuse osteoporosis and may result into fracture elsewhere in the body. Surgical
intervention may be necessary to provide quality life in this age group of patients.
Unfortunately, open surgeries are a challenge in geriatric terminally ill patients as they may not
tolerate such extensive surgeries and may succumb to surgically induced trauma to the body.
Therefore, minimally invasive pin-hole treatments such as Vertebroplasty or Kyphoplasty can be
an answer to this delicate clinical problem. Both surgical procedures have been shown to improve
acute pain and disability associated with VCFs without increasing morbidity of the patient. So far,
both Balloon Kyphoplasty and Vertebroplasty are well accepted treatments for VCFs.
According to various studies, Osteoporosis affected population in India would be around 25
million. 20 percent of women and 10-15 percent of men aged above 50 are Osteoporotic.
But Osteoporosis, a disorder characterized by a decrease in the density of bone and bone mass
resulting in fragile and weak bones, is largely under diagnosed and under-treated in India. The
problem is particularly worse in rural and semi-urban areas. In urban regions, Osteoporosis is
widely prevalent due to poor lifestyle pattern of the people. In general, 83 percent of all spinal
fractures are caused by Osteoporosis. Another common area affected by osteoporosis is the hip
bone.
The theme of the World Osteoporosis Day, which falls on the 20th of October this year, is “Don’t
bend to Osteoporosis”. This is an important day for informing and educating the general public
as well as the health care personnel about the prevention of a disease, which still suffers from poor
general awareness.
Dr. Rajesh Jain further said, “The major osteoporotic fractures occur in the spine, wrist
and the hip bones. Between 25% and 60% of women, aged over 60 years develop spinal
compression fractures. There are two interesting features about the osteoporosis in India -
the high incidence among men and the lower age of peak incidence as compared to Western
countries. The incidence of osteoporotic hip fractures is 1 woman: 1 man in India, while in the
Western world, it is 3 women: 1 man. And in most Western countries, while the peak incidence of
osteoporosis occurs at about 70-80 years of age, in India it afflicts those at age 50-60.”
Hence, the best prevention for osteoporosis is to build strong bones and maximize peak
bone mass before early adulthood. From the mid-thirties, there is a gradual, progressive bone
loss, which continues throughout life and is accelerated at the menopause in women. |
