“Does injecting cement into spine fractures make a difference?”
Osteoporosis has become a big issue since the turn of the century with an estimated 10 million Americans affected with the disease. Simplistically, low bone density (osteoporosis) means decreased bone strength and increased risk of fractures. Spine fractures from weak bone or Osteoporotic Vertebral Compression Fractures (OVCF) are the most common type of weak bone fractures seen in the U.S.
A recent commentary in the AAOS NOW (American Academy of Orthopedic Surgeons) debated the benefits of cement injection to stabilize spine fractures. The two types of procedures: Vertebroplasty (injecting cement into a collapsed spine bone) and Kyphoplasty (injecting cement into a balloon that has expanded inside a spine fracture) are the techniques being used currently.
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In the U.S., cement procedures started in the early 2000’s after the early success in Europe in the 1990’s. However, after an extensive literature review in 2009 challenged the benefits of these surgeries, the procedures declined significantly. Many good quality studies concluded that surgery was no better than conservative care. Patients seem to get better on their own!
What’s the right answer? As with most decisions in life– it depends! I personally have seen great results with kyphoplasty in patients who were not improving with conservative care. I have also seen wonderful results in patients treated with bracing and NO surgery.
Ultimately, the decision for surgery involves a frank discussion between the patient and Doctor. While in most cases, spine fractures from osteoporosis heal; there is a role for surgery in patients who do not improve with conservative care for OVCF.
Paul Saiz, M.D.