New Technique Provides Significant Pain Relief for People with Osteoporosis

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NEW TECHNIQUE PROVIDES SIGNIFICANT PAIN RELIEF FOR PEOPLE WITH OSTEOPOROSIS

San Francisco -- People with osteoporosis who suffer from painful compression fractures of the spine may find relief thanks to a new minimally invasive technique developed by interventional radiologists. Information on the technique was presented here today at the 23rd Annual Meeting of the Society of Cardiovascular & Interventional Radiology (SCVIR).

The new technique, called percutaneous vertebroplasty (PV), offers hope to people who previously have had no options other than narcotics and other pain killers.

"Ninety percent of the patients got pain relief," said John D. Barr, M.D., an interventional neuroradiologist and chief of neuroradiology at Penn State University College of Medicine, Milton S. Hershey Medical Center, Hershey, Pa. "It's often very dramatic. Some patients who were formerly on intravenous narcotics are now able to do without pain killers. I've had patients who were bedridden who were able to walk again the day after the procedure."

Osteoporosis, or brittle bones, affects 10 million people in the United States and each year leads to 700,000 painful vertebrae compression fractures caused by the collapsing of the weakened bones, according to the National Osteoporosis Foundation. Although in some people the fracture stabilizes on its own and the pain goes away, in others it persists, most likely because the crushed bone continues to move and break, said Dr. Barr. PV stabilizes the break, thereby alleviating the pain.

An interventional radiologist inserts a large needle through the skin and into a crushed vertebrae in the middle or lower spine. Such fractures are less common in the upper spine. Under X-ray and computed tomography (CT) guidance, the doctor stabilizes the vertebrae by filling it with a surgical bone cement. Dr. Barr has filled up to four crushed vertebrae in the same procedure. The procedure takes 1 to 2 hours and is typically performed while the patient is under general anesthesia.

"It makes the vertebrae extraordinarily strong, even stronger than normal bone," said Dr. Barr. "It treats the pain and prevents further collapse. Unfortunately, it can't return the vertebrae to its former size."

Although vertebrae compression fractures can be caused by trauma, such as a car accident, or cancer (which weakens the bone), osteoporosis is the most common cause, said Dr. Barr. A majority of his patients are women aged 60 to 80 who suffer from osteoporosis. Surgery has not been an option because the screws and hardware typically used in spine surgery wouldn't hold in the brittle bone.

Dr. Barr will present his study results on 28 crushed vertebrae in 16 patients with osteoporosis, 8 of whom had complete or marked pain relief and 6 of whom had moderate relief after an average one-year follow-up. Two had no significant relief. He also will report on 5 patients with 7 vertebrae fractures caused by cancer that had spread to the spine. Although PV stabilized the fractures in 4 of those patients, only 1 reported significant pain relief.

Although it is relatively new in this country, PV has been performed for more than a decade at several centers in France with excellent results, said Dr. Barr. About 100 of the procedures have been performed at Hopital R. Salengro, in Lille, France. In the United States, PV also is being performed at a few centers, and Dr. Barr expects the technique will be more widely available soon.

Co-authors of a paper on the topic presented by Dr. Barr at the SCVIR meeting are Michelle Barr, M.D.; Thomas Lemley, PA-C; and Richard McCann, RTR.

An estimated 1,700 physicians are attending the annual scientific meeting in San Francisco of SCVIR, a professional society of more than 3,000 members based in Fairfax, Va., for physicians who specialize in minimally invasive interventional procedures.

An interventional radiologist is a physician who has special training to diagnose and treat illness using miniature tools and imaging guidance. Typically, the interventional radiologist performs procedures through very small incisions in the skin, about the size of a pencil tip. Interventional radiology treatments are generally easier for the patient than surgery because they involve smaller incisions, less pain and shorter hospital stays. # # #