LOS ANGELES, Calif. (Ivanhoe Newswire) - Imagine constant pain so severe it changes your life. That's what many people who have fractured vertebrae live with every day. From car wrecks to osteoporosis to cancer, the fractures can be caused by many things, but there wasn't much out there to help people. Doctors now have a way to filltheir patients' pain relief needs.
Running, fishing, raising horses… nothing could stop Mary Ann Weyer, foster mom of six.
"I didn't have any worries about health," she told Ivanhoe.
Then one day, everything changed.
"It happened so fast. Bing. Bing. Bing. One day I was healthy, the next I was in the hospital, the next day I had broken bones," she said.
Within six months, she was diagnosed with multiple myeloma, a type of cancer where plasma cells in the blood grow rapidly and cause bone destruction. Radiation sent her cancer into remission, but she was left with six spinal fractures.
"I had no idea what people went through when they had pain, until it happened to me. For me the cancer wasn't scary. It was the idea of not being able to take care of myself and being incapacitated," she said.
Interventional neuroradiologist Dr. Marcel Maya at Cedars Sinai uses balloon kyphoplasty to fix the problem.
"This is an internal cast, where we put cement inside the fractured spine," Dr. Maya told Ivanhoe.
It's non-surgical, so there are no incisions. Instead, four needles are inserted into Mary Ann's back, creating a small pathway to the fractures. Orthopedic balloons are inserted and inflated.
"You can see the balloon getting thicker," he said.
Then, the cement fills the opened area.
"You see the cement filling the spine and restoring the normal height and strength," he continued.
Two hours after the procedure, Mary Ann's on her way home, scar free, pain free and ready to live again.
"To not have pain, is to have life," Mary Ann said.
Besides this treatment there is little help for people with spinal fractures. They are basically told to go home and rest. Recovery can take one to three months. With balloon kyphoplasty, recovery is usually less than ten days.
BACKGROUND: Multiple myeloma is cancer that starts in the plasma cells in bone marrow. Bone marrow is the soft, spongy tissue found inside most bones. It helps make blood cells. Plasma cells help your body fight infection by producing proteins called antibodies. In multiple myeloma, plasma cells grow out of control in the bone marrow and form tumors in the areas of solid bone. The growth of these bone tumors makes it harder for the bone marrow to make healthy blood cells and platelets.
SYMPTOMS: Multiple myeloma causes a low red blood cell count. This makes you more likely to get infections and have abnormal bleeding. If the bones in the spine are affected, it can put pressure on the nerves, resulting in numbness or weakness of the arms or legs. Other symptoms include bleeding problems, brittle bones that are more likely to break, fatigue due to anemia, fevers without any other cause, and shortness of breath due to anemia. (Source: www.ncbi.nlm.nih.gov).
TREATMENT: If you have multiple myeloma and aren't experiencing any symptoms, you may not need treatment. However, your doctor will regularly monitor your condition for signs the disease is progressing. If it is, you may need treatment. ( Source: The MayoClinic)
NEW TECHNOLOGY: Balloon Kyphoplasty is a minimally invasive procedure that can repair spinal fractures. It takes about an hour per fracture level to treat a fracture with Balloon Kyphoplasty, and the procedure can be done on an outpatient or inpatient basis. Balloon Kyphoplasty can reduce or eliminate your back pain from a spinal fracture, as well as restore vertebral body height and proper alignment of your spine. Early and effective treatment (fixing the broken bone) may reduce the consequences of spinal fractures, especially those associated with other treatments, for example, prolonged bed rest or use of analgesics. Other benefits include sustained improvement in mobility, improvement in ability to perform activities of daily living, and improved quality of life. Although the complication rate with Baloon Kyphoplasty have been demonstrated to be low, as with most surgical procedures there are risks associated with the procedure, including serious complications. (Source: www.medtronic.com)
Marcel Maya, MD, an Interventional Neurolradiologist at Cedars-Sinai Medical Center, talks about relieving back pain almost instantly.
Who's more susceptible to spinal fractures?
Dr. Maya: In general, elderly people especially ones who have osteoporosis, weakening of the bones and women more common than men.
How about cancer patients?
Dr. Maya: Some cancer patients are at risk for fractures because of specifically multiple myeloma. These attack the bones and cause osteoporosis and result in fractures even at a younger age.
Is spinal fracture pain are worse than osteoporosis and cancer pain?
Dr. Maya: They are actually the thing that brings the patients to the doctors. They complain most of the fracture related pain more than anything else that's going on in the body. Obviously cancer is important for their survival and wellbeing, but the thing that keeps them down in bed and not able to conduct their activities is the fractures and the pain.
What could you do for them before?
Dr. Maya: Before we used to give them a brace and hope that the fracture heals fast enough for them to get out of bed, but sometimes that fails.
Is it usually not a quick process?
Dr. Maya: Of course not because they're battling with other problems and they are not able to heal. They're set back and that prolongs their misery.
What is balloon Kyphoplasty?
Dr. Maya: What we do is we inject cement into the fracture in the spine. With the help of the balloon, we inflate the balloon inside the fracture and restore the vertebral body of the spine to its normal shape. That really helps with the pain and restores height.
Is it a long term solution?
Dr. Maya: It is long term as far as pain is concerned, but it doesn't prevent the patients from having other fractures in the future in other spine segments.
Does it give immediate relief then?
Dr. Maya: Most of the time there's immediate relief, but it may take a few days to a week or two to get back on their feet because they have lost so much strength and balance from lying in bed.
Is it a hundred percent recovery?
Dr. Maya: For most it's almost a hundred percent recovery.
What's the recovery time?
Dr. Maya: With the brace and doing nothing other than conservative measures, it may take up to four to six weeks for the fracture to heal. In some cases longer, in some cases shorter. With balloon kyphoplasty, recovery times are usually more in line of two weeks.
Is it minimally invasive?
Dr. Maya: It is minimally invasive. It's done as an outpatient. In some cases if the patients are not in the hospital and they can go home at the end of the day. There are no sutures; there is no scar and it's done through small holes in the skin.
How is the procedure done?
Dr. Maya: The procedure is done in the special angiography operating room where the patient is on their stomach. We put small incisions in the back and put spinal needles into the fractured spine. We then drill into the spine and inflate balloons so that there's a good cavity and restoration of the spine fracture. Once that's done, we put cement in there and deliver the cement under x-ray visualization and then we pull out all the needles and just apply some tape.
What's the cement made of?
Dr. Maya: It's called medical cement. Its chemical name is methacrylate.
Can you talk about Maryanne?
Dr. Maya: She was in very bad shape both psychologically and physically because she had been suffering with fractures for a number of months. She had the diagnosis of multiple myeloma and she was being treated for that. However, her spinal fractures were not addressed and she was in constant pain. She had told me that prior to this she was a very active person and that really set her back physically, mentally, psychologically.
Have you seen her since the operation?
Dr. Maya: I have seen her and she has really made dramatic recovery. Her pain is significantly reduced, almost gone, and she's back to herself and much more active.
Could you tell that the pain was gone?
Dr. Maya: Absolutely. The follow up that I had after the procedure, she was almost a different person.
What are the drawbacks of conservative therapy?
Dr. Maya: Some patients do not respond to that and they're in bed and they can't get up. I would compare it to fixing a long bone fracture where you put an external cast outside the arm or the leg. This one is an internal cast where we put the cement inside the fractured spine.
Does the cement ever go away?
Dr. Maya: It's there for life.
FOR MORE INFORMATION, PLEASE CONTACT:
Becky Allegretto Cedars-Sinai Medical Center S. Mark Taper Foundation Imaging Center (310) 423-8694
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