4 minute read
Minimally invasive procedure used to treat osteoporosis, spinal fractures and severe back pain
Straight &tall
Minimally invasive surgery turns back the clock on age-related vertebral
Cproblems
Carmen Mottu
CARMEN MOTTU IS A BUSY WOMAN. SHE’S AN ACTIVE MEMBER OF THE RED HAT SOCIETY, a women’s organization whose members are identifiable by their red hats and purple attire. She loves to travel, visiting New York City for the first time last year, walking nonstop to places like the Empire State Building and Times Square. And she has 11 grandchildren who keep the 73 year old on the go.
Last year, Mottu would have told you a very different story. What she thought was a pinched nerve quickly developed into a pain so intense, she couldn’t drive over a bump in the road without crying out in pain.
Osteoporosis affects 44 million Americans and causes more than 700,000 vertebral compression fractures annually in the United States.
Normal
Fractured
I“IT WAS EXCRUCIATING,” said Mottu, who retired from Nabisco after 40 years. “I couldn’t even roll out of bed without crying, it hurt so bad.”
Initial X-rays showed a fracture in her vertebra. The diagnosis: osteoporosis — bone loss and softening of the bones, which can be caused by age, hormonal imbalances or diets deficient in calcium. Osteoporosis can result in one of the manysections of the spinal column weakening and fracturing, leading to severe pain, vertebral and hip fractures, and in some cases a severe hunchback.
Mottu’s primary care physician recommended she see Dr. Hani Haykal, director of neuroradiology at the Methodist Neurological Institute. Haykal is an interventional neuroradiologist who specializes in spine treatments, particularly a procedure called kyphoplasty for vertebral fractures caused by osteoporosis.
“Osteoporosis, spinal fractures and severe back pain can all be treated using this procedure,” Haykal said. “Patients, especially women, need to understand that by age 50, a woman has a 40 percent chance of suffering an osteoporosis-related fracture in her lifetime. That’s right up there with the risk of breast, uterine and ovarian cancer combined.”
In May 2006, Haykal performed the minimally invasive procedure on Mottu. After administering local anesthesia and intravenous sedation to the patient, Haykal made two small incisions on each side of the fractured vertebra. He inserted two metal tubes — smaller than ordinary drinking straws — into the broken bone, then threaded a balloontipped catheter through the tube and used the inflated balloon to restore the vertebra to its original shape and improve its alignment.
Finally, he removed the balloon and packed the vertebra with acrylic cement, a durable and permanent version of standard orthopedic cement. The procedure took a little more than an hour.
Mottu, who went home the next day, says she remembers a little soreness after the procedure but nothing compared to the pain she felt before.
Kyphoplasty lessens the acute pain and disability associated with vertebral compression fractures, as well as restores body height and shape. This procedure also may reduce the risk of experiencing another fracture.
Dr. Hani Haykal
About 95 percent of Haykal’s patients report significant or total pain relief within a few days after the procedure. Even with this success, Haykal says many family physicians and patients do not know this treatment is available.
Aside from kyphoplasty, the standard medical treatment for osteoporosis-related pain is bed rest, narcotics or cumbersome braces. According to Haykal, conventional therapies don’t always work, and bed rest can actually worsen bone loss. Narcotics can alter a person’s state of mind, and patients frequently dismiss braces as too difficult to use. “Kyphoplasty works and it works well,” he said.
Osteoporosis affects 44 million Americans (women more than men), causes more than 700,000 vertebral compression fractures annually in the United States and accounts for $18 billion in annual health care costs.
Haykal is training fellow physicians in kyphoplasty because of the number of patients seeking help and because he wants more physicians to be informed about diagnosing and treating spinal fractures caused by osteoporosis. He also is researching other potential uses for the minimally invasive surgery, including use on patients with spinal fractures caused by certain types of cancers, like myelomas.
As for Mottu, she says, “I’m 73, but I tell my grandkids I feel like I’m 27.”
To learn more about kyphoplasty or to schedule an appointment, call 713.790.3333.
The balloon is inserted into the fractured vertebral body via the tube. The balloon is inflated, reducing the fracture and elevating the endplates.
Once the vertebra is in the correct position, the balloon is deflated and withdrawn, leaving a cavity within the vertebra.
The cavity is filled with a special cement to support the surrounding bone and prevent further collapse. The cement forms an internal cast that holds the vertebra in place.
