Osteoporosis is a disease of the bone in which the bones become too weak and brittle. Normally the body keeps replacing the old bone tissue with new one but in osteoporosis the rate of replacement or new bone creation doesn’t keep up with the rate of bone removal. Consequently the body makes too little bone or loses too much of it. Because of low bone density and structural bone deterioration they become weak and can break more easily from a fall or in worst case scenario even from sneezing.

Although the bones become weak due to osteoporosis, there is no pain involved or other obvious symptoms.

Complications from this condition can result in breakage or fracture of the spinal bones as well. These spine fractures are called vertebral compression fractures and can cause immense back pain and severely restrict the patient’s mobility.

Treatment & Prevention of Spinal Osteoporosis

Most patients who suffer a vertebral compression fracture get well with the help of nonsurgical treatments but if you have osteoporosis also and your pain doesn’t get better with this type of treatment Dr. Anil Dhingra, the leading spine expert in Chandigarh would recommend surgery.

Kyphoplasty

Kyphoplasty is a minimally invasive vertebral augmentation procedure to treat acute fractures of the vertebrae. Kyphoplasty has the advantage to reduce the malalignment of the spine and it restores the height of vertebra.

How is kyphoplasty procedure performed?

The procedure is done under the local anaesthesia.  It is done by putting a needle in the fractured bone under fluoroscopic guidance and then inflating a balloon (called the balloon tamp) to restore bone height, leaving a small cavity which is injected with special bone cement (called polymethylmethacrylate) into the vertebral body. Entire procedure takes less than an hour. It is a stitchless procedure, i.e. no suturing is required on puncture wound. Once the surgery is done, the patient can resume normal day-to-day activities without much restrictions or delay.

Vertebroplasty

Vertebroplasty is an almost similar technique; only difference is that we don’t do balloon expansion of the vertebral fracture, as expansion may not be needed in these cases. Vertebroplasty has the advantages of simplicity and lower cost. The surgeon will inject the bone cement directly into the fractured vertebra. The patient lies on his/her back face down and the surgeon performs the procedure on the vertebra from the back.

How safe is the kyphoplasty/vertebroplasty ?

Both procedures are very safe in expert hands. Complication rates are less than 1%. Symptoms improve in around 95 % of patients. This procedure is safe even in very elderly patients and usually done only in old patients.

How long it will take to recover?

Normally, patient is able to walk same day with significantly decreased pain. The patient  is discharged in a day after surgery, but should refrain from heavy weight lifting and prolonged travelling for at least 3 months. Doctor will recommend you medications and follow-up examination on OPD basis and radiological investigations to look for healing and to recover faster and prevent further spine- related problems.

What are the Indications of Minimally Invasive Spine Surgery (MISS)? –

  • Acute vertebral osteoporotic fractures ( less than 3 months old)
  • Some traumatic vertebral fractures
  • Painful vertebral hemangiomas.
  • Painful pathological fractures such as multiple myeloma, spinal metastases.

Why is it required?

Treatment of osteoporotic fractures usually consists of bed rest for at least 6 weeks , pain control, calcitonin and narcotics and spinal bracing. This regimen is usually effective and most people will mostly recover.  A substantial number of patients will fail to heal within 6 weeks and these require the surgery. Some patients who don’t accept bed rest do better with it.

Contraindications-

  • Recent systemic or spinal infection.
  • Uncorrected bleeding diasthesis/problems
  • Very poor cardiopulmonary health.
  • Fracture -related spinal canal compromise.

For more information on spinal osteoporosis and its treatment contact Dr. Anil Dhingra, the leading spine surgeon in Chandigarh.

Source: webmd.com, spine-health.com, orthoinfo.aaos.org