Cement injections used to treat back pain

May 12, 2009 5:46:55 PM PDT
Compression fractures in the back are one of the most painful and debilitating injuries older folks deal with. But now, new surgical techniques are allowing doctors to literally re-expand a crushed vertebra.

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In his years as a Navy pilot, Captain Marland Townsend never had to hit the eject button. But he hit the ground hard a few months ago, bending down to feed his cat.

"And this foot slipped out from under me, boom. I didn't fall backwards, I rotated all the way around because this was holding me up and I just dropped from this height to the floor," said Captain Townsend.

The result was a crushed vertebra in his lower back.

"You don't even want me to describe it, it's excruciatingly painful," said Captain Townsend.

The injury led him to Dr. Paul Slosar, an orthopedic surgeon at St. Francis Hospital's Spine Center in San Francisco.

"You can see that big divit where the fracture bone is down, and I outlined the normal one here so that you can see how tall that looks. You can see very easily how the fracture had reduced the height about 70 percent," said Dr. Slosar.

As recently as a decade ago, Dr. Slosar said the injury could have meant months of bed rest, or even major surgery.

"Many of these patients who had vertebral fractures became chronic pain patients, and many of them led their spines would deform more and more," said Dr. Slosar.

The St. Francis team opted for a minimally invasive technique inserting a hollow needle directly into the damaged vertebrae.

"That allows us to move inside the vertebrae and create a little space," said Dr, Slosar.

The space is then filled with a new kind of bone cement called StabiliT, developed by a company in San Jose.

The system uses radio frequency to heat the cement, allowing it to flow evenly through the needle, into the bone.

As it sets, the cement expands, pushing outward and helping to restore the height of the collapsed vertebrae.

"If you look at smallest footprint surgery we can perform, this is about as minimal invasive as you can get," said Dr. Slosar.

Once hardened, the cement is as rigid as the natural bone around it. Captain Townsend said the effect on his pain was almost immediate.

"Honestly, as soon as I wake up in the recovery room, the pain is absolutely gone," said Captain Townsend.

Doctor Slosar said the repaired vertebra functioned normally, without putting pressure on any of the surrounding discs, and it helps patients get back to their lives.

There is also a competing technology for treating compression fractures. It uses a balloon to raise the height of the compressed vertebrae, before surgeons inject the bone cement.

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