3 minute read
Dr. James Webb
Today’s Science: Solutions for Back Pain
What is Kyphoplasty? Does it Relieve Chronic Back Pain?
A vertebral compression fracture is often the fi rst sign of osteoporosis, but they are usually missed by imaging. For example, 86% of VCFs are missed on advanced CT. VCFs are also associated with high rates of death if left untreated. A recent analysis of the entire Medicare data set showed that for patients with a VCF, only 15% will survive 10 years. However, the same analysis showed that kyphoplasty more than doubles the survival rate of these patients.
What is Kyphoplasty?
Kyphoplasty is a minimally invasive procedure that quickly repairs vertebral compression fractures (VCF) and restores structural integrity to broken vertebral bone. Kyphoplasty is an outpatient procedure that uses a cavity creation device (usually a balloon) to create a space in the broken vertebra which is then fi lled with a special bone cement to stabilize the fracture and reduce pain.
How does Kyphoplasty help?
The goal of kyphoplasty is to restore the broken vertebra to a more normal height and to fi x the pain caused by the fracture. When a vertebral fracture occurs, it most commonly presents as an acute worsening of chronic lower back pain. Many times the patient’s chronic back pain is getting worse, but it’s actually due to a recent fracture. Many of our patients experience immediate pain relief following kyphoplasty. It can help relieve pain by stabilizing the fracture. Improved mobility results because of decreased pain levels.
What happens during the Kyphoplasty procedure?
• Needle Placement - Under IV sedation and using x-ray guidance, a
pencil-sized needle is placed through a small (quarter-inch) incision and a working channel is made in the fractured vertebral body. • Cavity Created – A balloon is generally used to create a space and to reduce the fracture to more anatomic alignment. • Devices Removed – The balloon is defl ated, leaving a cavity in the vertebral body. • Fracture Stabilized – The cavity is fi lled with bone cement to stabilize the fracture. Once fi lled, the incision is closed. • End of Procedure – With the process completed, an internal cast is now in place. This stabilizes the vertebral body and provides rapid mobility and pain relief. • The procedure takes about 30 minutes and has a short recovery time, usually a couple of days for most patients.
After Kyphoplasty
Patients treated with balloon kyphoplasty have signifi cantly better outcomes in terms of pain reduction, quality of life, function and mobility both initially at one month, and throughout the months and years after treatment. 94% have complete or signifi cant pain reduction and 67% have improved mobility. While kyphoplasty is highly effective for improving mobility and decreasing pain in patients with spinal fractures, it does not treat the underlying osteoporosis itself. It’s important for your doctor to treat the underlying bone disease (osteoporosis) causing the fractures. This decreases the risk of future fractures and generally makes spinal fractures less frequent.
Kyphoplasty vs. Vertebroplasty
Kyphoplasty and vertebroplasty are both medical procedures designed to treat pain associated with vertebral compression fractures. The main difference is vertebroplasty does not create a cavity and there is higher likelihood of cement leakage. Kyphoplasty has a signifi cantly lower complication rate compared to verteboplasty and more than doubles the 10-year survival rate in patients over 65.
Dr. Webb – Kyphoplasty Expert
When it comes to kyphoplasty, Dr. Webb is one of the most experienced physicians in the US. Dr. Webb has performed thousands of kyphoplasty procedures and has the experience necessary to safely perform kyphoplasty. In fact, he also teaches other physicians how to safely and effectively perform the procedure. Here are a few facts about Dr. Webb’s kyphoplasty expertise: • He performed over 120 kyphoplasties during his training (fellowship). • Was one of the fi rst physicians to perform kyphoplasty in Oklahoma. • Was a principal investigator in the EVOLVE trial, the largest ever on-label study of kyphoplasty in
Medicare patients with vertebral fractures with 350 patients enrolled over 24 sites across the US. • The fi rst in Oklahoma and one of a few in the nation to establish a full-service outpatient clinic focused on medically treating the underlying causes of osteoporosis in patients with VCF.. • The highest level of experience in the Tulsa area with 300-400 fractures treated per year. • Continues efforts to refi ne vertebral fracture treatment, consulting for numerous medical device companies and teaching other physicians how to perform this life-saving procedure.