Managing pain is an unfortunate problem for many patients. Often pain can be controlled with over the counter medications, or in more severe instances, prescription pain relievers. For many patients, pain specialists and anesthesiologists will play a primary role in pain management. In some cases, interventional radiology producers may help manage pain, particularly for patients experiencing certain types of spine and neck pain.
Kyphoplasty and Vertebroplasty
Kyphoplasty and vertebroplasty are minimally invasive procedures used to relieve the pain from a vertebral fracture, especially if it does not improve after several weeks of pain medication and treatment with a brace. Both vertebroplasty and kyphoplasty procedures involve placing cement into the fractured vertebra through small incisions in the skin under x-ray guidance.
Certain diseases, such as osteoporosis or cancer, are known to cause loss of bone mass and changes in bone structure, making them brittle and weak. Genetic factors and certain lifestyles, such as a low calcium diet, can also damage bone. Over time, the vertebral bodies can become so weak that normal activities such as bending over or lifting a bag of groceries, can cause a spinal fracture.
Sacral insufficiency fractures, a subtype of stress fracture, can cause debilitating lower back pain. These fractures are typically caused by osteoporosis and occur in the pubic bone or sacrum, the triangular bone in the lower back situated between the hip bones in the pelvis. Standard treatment requires prolonged bed rest and the associated complications that result from immobility. Some patients, however, may experience pain relief from vertebroplasty.
Back pain due to vertebral fractures or cancer involving the spine can be treated with kyphoplasty in some instances. This treatment involves using a balloon to restore the vertebral body height in conjunction with injection of a special cement to maintain the strength of the damaged area.
- Bone cement is injected under pressure directly into the fractured vertebra.
- Once in position, the cement hardens in about 10 minutes, congealing the fragments of the fractured vertebra and providing immediate stability.
- A balloon catheter is guided into the vertebra and inflated with a liquid under pressure.
- As the balloon inflates, it can restore the collapse in the vertebra and correct abnormal wedging of the broken vertebra.
- Once the balloon is maximally inflated, it is deflated and removed, and the large cavity created is filled with bone cement.
- The cement then hardens in place, maintaining any correction of collapse and wedging.
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