“When the skeleton is frail due to depletion of calcium, something as simple as a hard cough or picking up a grocery bag can cause a fracture,” explains Richard W. Reese, MD, Medical Director, Osteoporosis Center of Lancaster. Vertebral compression fractures also result from the constant pressure of one spinal vertebrae upon another—causing small cracks to develop. These fractures are painful and make it hard to stand up straight.

“Because of the loss of height and curvature of the spine, some patients even lose some lung capacity,” says Keith Kuhlengel, MD, Lancaster Neuroscience and Spine Associates.

Dr. Kuhlengel is one of three surgeons from his practice to use a relatively new procedure, kyphoplasty, to help people with compression fractures. Kyphoplasty dramatically reduces pain and restores height in the spinal vertebrae. In addition to Dr. Kuhlengel, Perry Argires, MD, and Christopher Kager, MD, are also experienced in the procedure. As a kyphoplasty instructor, Dr. Kager helps other doctors understand this minimally invasive technique, which is used by both neurosurgeons and orthopedic surgeons.

From start to finish, the operation takes less than one hour per vertebrae and can be done with local or general anesthesia on an outpatient or inpatient basis.

To determine if a patient is a good candidate for kyphoplasty, surgeons determine the age and location of the fracture(s) using MRI and CT scan technology. The results will tell the surgeon if the patient’s bones are strong enough to handle the procedure.

Kyphoplasty involves making a small incision (1/2 inch) in the patient’s back. The surgeon inserts a narrow tube through the opening and into the fracture. Once the tube is in place, the surgeon carefully inflates a surgical balloon threaded through the tube into the bone. The pressure compresses the soft inner bone of the vertebrae and creates an opening, or cavity. The surgeon then removes the balloon and fills the cavity with bone cement, a material that hardens quickly and does not damage the bone.

Before kyphoplasty, doctors could offer patients limited treatment options, which included wearing a back brace or vertebroplasty. The back brace can be uncomfortable and takes time to get fitted correctly. Vertebroplasty, a procedure similar to kyphoplasty, has a greater risk of spreading surgical cement outside the vertebrae itself. Neither option is as effective in restoring height.

“Kyphoplasty has a 90 percent success rate,” says Dr. Kuhlengel. “Many patients can tell a difference in pain in the recovery room.”

After surgery, physical therapy and osteoporosis treatment can be key parts of a patient’s recovery plan.

“People with compression fractures often don’t go to the doctor right away and because of the pain, they may not be able to comfortably do their normal activities,” Dr. Kuhlengel says. “After kyphoplasty, once we get the pain under control, patients may undergo physical therapy to rebuild their stamina.”

Patients should also talk with their doctors about what they can do to treat osteoporosis and prevent further fractures. Osteoporosis affects 25 million women in the United States and 5 million men. Nearly 1.5 million people suffer from an osteoporosis-related fracture each year.

“Treating osteoporosis is two-fold," explains Dr. Reese.” First, you need to determine how to increase your calcium intake. Incorporating more calcium by eating calcium-enriched foods may work for you. Other people may need to increase their calcium absorption with the help of calcium supplements or medications. The second component to consider when you have osteoporosis is to assess your risk of falling and to take steps to prevent accidental falls (installing non-skid strips in the shower, moving throw rugs, etc.).”

If you have ongoing back pain and think you may have a compression fracture, talk to your family doctor. Even if you are feeling perfectly healthy, women over the age of 65 should be screened for osteoporosis and men over the age of 70 should also talk to their doctors about their risks. For an educational brochure, please call the Osteoporosis Center of Lancaster at 544-3759.