Kyphoplasty: It's Hard to Pronounce but Invaluable in the War Against Osteoporosis

May is National Osteoporosis Awareness and Prevention Month

Osteoporosis is one of the most common diseases. 54 million Americans have osteoporosis or weak bones. This increases the risk of “fragility fractures.” Many think hip fractures are the most common type of fragility fracture. Instead, fractures of the spine called “vertebral compression fractures” or VCFs, are the most common type of fragility fracture.

Prevention, by focusing on bone health throughout our lives, is vital. Risk factors include smoking, cancer, insufficient calcium intake, and low vitamin D. Studies estimate that 1 in 2 women or 1 in 4 men aged 50 or older will sustain a fragility fracture in their lifetime. VCFs often occur with a minor fall or lifting. But many happen with trivial activities such as coughing or rolling over in bed.

To make matters worse, VCFs often go unrecognized or untreated. Diagnosis can be made with a simple X-ray. Patients can have little-to-no pain or have pain so severe they cannot get out of bed and require hospitalization. Pain is worse when a patient tries to get up and move around.

When patients suffer a VCF, conservative care is the first step. This may include bedrest, pain medications, or bracing. However, bedrest worsens osteoporosis, pain pills increase the risk of additional falls, and patients often do not tolerate bracing. In my practice, I see too many patients who fail conservative care but are never offered a different treatment, kyphoplasty (pronounced “KY-foh-plas-tee”).

Not every patient with a VCF requires kyphoplasty. If patients are not improving with conservative measures, kyphoplasty should be strongly considered. In fact, patients who only receive conservative care have a 55% higher mortality at 1 year. Why is this? The pain from a VCF sets off a cascade of undesirable events like being bed-bound (increased risk of blood clots, muscle wasting), worsened breathing mechanics (increased risk of pneumonia), sleep disturbance, and decreased appetite. All of which increase mortality. The term conservative care connotes lower risk and better outcomes. In the case of VCFs, “conservative” care is often the higher-risk approach with inferior outcomes. Kyphoplasty helps patients avoid this downward spiral.

So, what is kyphoplasty? It is a minimally invasive, low-risk, outpatient procedure (not surgery). Like treating any fracture, the goals are to re-align and fixate fracture which eliminates pain. The patient is sedated or put under anesthesia and numbed up. Because the fracture is within the spine, it is accessed via a needle. Next, the fracture is reduced (re-aligned) with either a balloon or an implantable “spine jack” to restore the fracture to normal height. Finally, bone cement is carefully instilled and acts like a cast, fixing the fracture. Patients feel near-immediate pain relief and resume normal activities immediately. Kyphoplasty also restores normal anatomy which prevents worsening or additional fractures.

The sooner kyphoplasty is performed, the better. If you or someone you know is suffering with a recent VCF, consultation with a board-certified interventional physician, especially one who is well-versed in the most modern kyphoplasty techniques, can be a life-saving step.

To learn more about Kyphoplasty, and to see a list of FAQs about it, please click here.

Dr. Jason Williams, MD, is dual-board certified in both anesthesiology and interventional pain medicine. He practices at Saint Alphonsus Regional Medical Center in both Boise and Nampa. Dr. Williams is passionate about kyphoplasty as a tool to restore function and improve quality-of-life in his patients. He was also the first physician to perform the SpineJack procedure for vertebral compression fractures at Saint Alphonsus. To make an appointment, please call 208-367-2200.