Osteoporosis - The Brittle Bone Disease
Osteoporosis , a disease in which our bone's internal architecture is damaged so much so that bones becomes internally weak. Such bone can crumple under very trivial loadings and lead to insufficiency fractures. The effect of osteoporosis is most pronounced into the human spine because of its axial position and due to the internal structure of it's vertebrae. Mostly a disease of elderly.
This fractures can be silent. Meaning some vertebral fractures are without symptoms. We recognize such fractures only when we take an X-ray for some other reasons or when we notice bent (stooped) posture of the patient.
However, most are significantly symptomatic. Patients comes with history of very trivial fall, like missing a step, getting up from the ground, lifting a bucket of water etc.. following which the patient is in back pain. Pain is mostly continuous or occurs while loading conditions (standing, getting up from bed, walking, twisting, turning in bed etc).
Most patients do very well with medical management of 4 to 6 weeks. But some undergoes a non-union or persistence of fracture. These are the patients that are a surgical challenge.
Why they are a challenge?
They are geriatric ( elderly). Mostly accompanied with medical illnesses like Blood Pressure, Diabetic, Heart Disease etc. Hence, the surgical risk is greater. Already weak bones can not be securely fixed with screws and rods ( like fractures of leg bones ).
We have an option ... The Percutaneous Vertebroplasty
This is the procedure during which we insert a special wide bore needle without anaesthesia by just numbing the needle entry site on the skin. The needle is inserted under continuous fluoroscopic guidance. Via needle we inject specialised bone cement to internally fix the fractured vertebrae. The procedure needs only 20 minutes. Through out the procedure the patient is awake
The miraculous part is, patient is up and walking in next 3 to 4 hours with significant reduction or disappearance of the pain.
look at the following images that shows this procedure.
This fractures can be silent. Meaning some vertebral fractures are without symptoms. We recognize such fractures only when we take an X-ray for some other reasons or when we notice bent (stooped) posture of the patient.
However, most are significantly symptomatic. Patients comes with history of very trivial fall, like missing a step, getting up from the ground, lifting a bucket of water etc.. following which the patient is in back pain. Pain is mostly continuous or occurs while loading conditions (standing, getting up from bed, walking, twisting, turning in bed etc).
Most patients do very well with medical management of 4 to 6 weeks. But some undergoes a non-union or persistence of fracture. These are the patients that are a surgical challenge.
Why they are a challenge?
They are geriatric ( elderly). Mostly accompanied with medical illnesses like Blood Pressure, Diabetic, Heart Disease etc. Hence, the surgical risk is greater. Already weak bones can not be securely fixed with screws and rods ( like fractures of leg bones ).
We have an option ... The Percutaneous Vertebroplasty
This is the procedure during which we insert a special wide bore needle without anaesthesia by just numbing the needle entry site on the skin. The needle is inserted under continuous fluoroscopic guidance. Via needle we inject specialised bone cement to internally fix the fractured vertebrae. The procedure needs only 20 minutes. Through out the procedure the patient is awake
The miraculous part is, patient is up and walking in next 3 to 4 hours with significant reduction or disappearance of the pain.
look at the following images that shows this procedure.
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