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Your Painful Spine Fracture And a New Treatment 

Cleveland Clinic Myeloma Skeletal Clinic Publishes First results of the procedure in Myeloma Patients                                        


What is a vertebral body?

 Your spine is made up of 24 bones called vertebra.  These vertebrae are stacked one on top of the other to form the spinal column and allow you to stand upright.  The vertebral body is the thick block of bone at the front of each vertebra.

 What is a vertebral body compression fracture (VCF)?

 A VCF is a break in the vertebral body which causes it to collapse. This in turn, causes the spinal column above it to bend forward. 

What causes vertebral body compression fracture (VCF)?

 Bones are mainly made of calcium.  In general, bones progressively lose calcium with age.  Certain drugs, such as steroids, also cause calcium loss from bones.  When too much calcium is lost from a vertebral body, it becomes brittle and can easily break.  Even normal activities, like picking up a child or stepping off of a curb, can break a vertebral body made brittle by calcium loss. Multiple myeloma is associated with bony disease in over 70% of the patients.

 How are painful vertebral body compression fractures usually treated today?

 The usual treatment for a painful VCF is short-term bedrest, pain medication, and possibly, a body brace.

 Why should I consider a new treatment for my painful vertebral body compression fracture?

 Pain medications do not always stop the pain of a VCF.  The pain can last from weeks to several months.  Pain for months can mean that the vertebral body is collapsing a little at a time.

 Eventually, the vertebral body will stop collapsing and the bone heals.  This usually stops the pain.  Unfortunately, when the bone heals in a collapsed position, it creates a deformity that affects your posture.

 Once a deformity occurs, the problem cannot be corrected later without major surgery.  Also, the change in the shape of your spine contributes to an increased risk of more VCFs With each new VCF, your spine shortens and curves further forward.  This spinal deformity can affect your health and quality of life.  People with multiple VCFs have a greater risk of breathing problems, loss of appetite, chronic pain, and/or difficulty walking.

 What is the new treatment for painful vertebral body compression fracture (VCF)?

 The new treatment is a procedure performed by doctors using an inflatable balloon tamp.  The balloon allows the bone to be elevated into place through a very small incision (cut in the skin).  Your doctor inserts a small tube down to the bone and creates a path into the fractured bone.  The balloon tamp is inserted and inflated as your doctor watches using X-ray pictures.  The balloon tamp is designed to make a space, that can be filled with a bone cement.

 What are the likely results of this new treatment?

 If your fracture occurred recently (within the last few weeks), the collapsed bones could be restored back to their normal position.  Filling the space should reduce or stop the pain, and prevent the deformity.  If your fracture is older, the healing that normally occurs may stop the bones from moving back to their original position, but a space can usually be made.  Filling the space should reduce or eliminate your pain, and prevent further collapse of that vertebral body. 

 What else will happen if I have the new treatment?

 Your doctors will give you a standard medical examination and perform diagnostic studies (such as X-rays) to identify the vertebral body causing your back pain.  Your doctor may admit you to the hospital for one day.  You will be given  medication to relax you before the treatment.  The treatment can be done with you asleep or awake under local anesthesia.  Your doctor will discuss these options with you. After you go home, your doctor will ask you to return a few times for X-rays and a medical exam.  Your doctor will decide the schedule based on your overall condition. 

What are the possible results of the treatment?

 This treatment is designed to reduce or eliminate your pain, improve your quality of life, and it may also help to straighten your spine.  The sooner your fracture is treated, the more likely your doctor will be able to restore some, or all of the loss of height, reduce or eliminate the pain, and prevent further collapse of the treated bone(s).

What are the possible risks?

 As with any surgical procedure, there are potential risks.  Although the procedure has been designed to avoid these risks as much as possible, there is a chance that complications may occur.  You should speak with your doctor about the possible risks, benefits, and alternatives to this procedure or any other treatment.

 How can I learn if I am a candidate for this procedure?

 Mary Kay Reinhardt, RN


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