Osteoporotic Fractures: Which Procedure is Right for You?

Are you or a loved one at risk of osteoporosis? If so, you may already know that this disease causes bones to become fragile, putting people at risk for fractures around the body. Spinal fractures and pelvic insufficiency fractures (figure 1) are two common, potentially debilitating outcomes of osteoporosis. For those with these conditions, effective treatment is necessary not only to subdue the effects osteoporosis, but also to alleviate chronic pain. Osteoporosis will keep you at an increased risk of suffering another fracture to the same region. So, the goal should be to treat the condition in such a way in which you’re pain-free and at minimal risk of suffering another fracture to the same area.

Two options come to mind for those with spinal or pelvic insufficiency fractures: surgery or conservative treatment, pain medications with physical therapy. While surgery has numerous potential benefits, it is still the more invasive route. As a result, patients are hesitant to consider it, often looking toward surgery as the final step in treatment. Conservative treatment lacks the risks of surgery, but requires trust and patience. And yet, the chronic pain associated with fractures leaves one impatient, anxious to get back to their life unstifled by pain. Many prefer immediate results, and upon constant or progressive pain they lose trust in the medical process altogether. More options are available, however; options that are arguably more effective and appealing for sufferers of chronic pain.

Kyphoplasty and Sacroplasty are quick, efficient, and minimally invasive procedures that provide the immediate pain relief and minimal risks that other treatments lack. During Kyphoplasty, an inflatable tramp (balloon) is placed in the spinal fracture to create a channel. In this channel bone cement is filled, thus providing greater structural support in the fractured bone (1). This lessens the stress on the fracture and provides greater pain relief and comfort. Sacroplasty treats pelvic insufficiency fractures in a similar way‐‐filling said fracture with bone cement (Figure 2).

Figure (1): Axial T1-weighted MR image shows a small signal of sclerosis in lateral sacral crest, indicative of a sacral insufficiency fracture.

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Figure(2):Fluoroscopy image of the Whitlow Technique. Lateral view of needle entering the sacrum parallel  to sacroiliac joint. PMMA cement is being distributed into the lateral sacral crest.

Sufferers of chronic pain most often want one thing from their treatment: to return to their way of life prior to injury. Both procedures use bone cement to create an internal cast, stabilizing the fracture and providing immediate pain relief, as well as increased mobility (1,3).  Also, the stabilization of the bone can significantly minimize the likelihood of future fractures in that area. Additionally, Kyphoplasty restores vertebral height, which improves posture and outward appearance (1). The immediacy of the results is key. No one wants to spend months seeking treatments or constantly being on medication.

When engaging in a plan of action to treat a condition, the risks of each treatment resonate greatly. A person doesn’t want get in a situation in which their condition becomes worse. And while the benefits of Kyphoplasty and Sacroplasty are numerous, as with any procedure, there are risks. In both procedures, there are chances of possible infection, significant bleeding, and leakage of the bone cement onto surrounding tissue, causing paralysis (2,3). Although such occurrences are rare, making significant medical decisions requires complete information.

All in all, Kyphoplasty and Sacroplasty are safe and effective procedures, providing immediate results that most patients desire. These types of fractures are debilitating, and many live a poorer quality of life simply because they’re not made aware of the full arsenal of treatment options. Surgery and conservative treatment are no longer the only choices. Modern medicine has vastly improved, and with it, the quality of life for the patient. Treatments are constantly becoming quicker, more efficient, and provide overall greater patient satisfaction. Kyphoplasty and Sacroplasty are no exception. Although relatively new procedures in the field of medicine, they have the potential to change traditional methods of treatment. With so many medical innovations, it becomes crucial to understand the benefits of improved treatment options. A simple explanation can mean the difference between prolonged pain and immediate relief. So, this means that there will be a greater onus on patients to research their options in order to make the best decision for their well-being. Kyphoplasty and Sacroplasty are part of the new wave of modern medicine and because of their possibilities, they must be made known to the general public.