New Options for Pain Relief
Julie York, M.D., will discuss treatments for osteoporosisrelated fractures.

Osteoporosis is a silent disease-there are no symptoms associated with bone loss until a fracture occurs. In most people, bone loss begins in early adulthood. Bone loss increases as estrogen decreases at menopause. In the average woman, a 20 percent loss of bone mass occurs between the ages of 40 and 70.

The most common site of osteoporosis-related fracture is the spinal column. This type of fracture is called a vertebral compression fracture. On average, one out of every four women over the age of 50 has a compression fracture. The incidence of compression fractures increases to 40 percent in 80-year-old women.

Prevention first
"Preventing vertebral compression fractures is extremely important," says Julie York, M.D., a neurosurgeon.

A patient's primary-care physician, or an endocrinologist, often treats osteoporosis. Calcium supplements, vitamin D, hormone replacement therapy, bisphosphonates and calcitonin are used alone or in combination for this condition. Weight-bearing exercises and fall precautions also are important.

Treating the pain
When a vertebral fracture occurs, it can cause intense pain, usually lasting weeks to months. Patients may develop chronic pain, curvature of the upper back, loss of height and changes in self-image, leading to a significant impact on activities of daily living.

"Vertebroplasty and kyphoplasty are relatively new techniques that are being used to treat painful vertebral compression fractures," says Dr. York. Both techniques involve the injection of bone cement into the fractured vertebra. Kyphoplasty involves an initial infl ation of a balloon to re-expand the collapsed vertebra. According to Dr. York, "Pain relief has been reported in more than 80 percent of patients undergoing these procedures."

Using X-ray guidance and fluoroscopy, surgeons locate the fractured vertebra (1). They thread a cannula to the site of the fracture (2) and inflate a balloon to restore the height and anatomy of the bone (3), creating a space within the fractured vertebra. Then doctors remove the balloon and inject a bony paste or cement into the space to stabilize and support the spine (4).

Ideal candidates for vertebroplasty or kyphoplasty have mostly activity-related pain that corresponds to the level of a recent compression fracture. This pain typically lessens or disappears completely when the person reclines or sits still. Imaging studies, such as X-rays and MRIs, are necessary to make the diagnosis. The procedure generally does not require general anesthesia and is often performed in an outpatient setting.

Learn More
Attend our September health forum, "Treating Osteoporosis-Related Fractures: How Vertebroplasty May Help," presented by Julie York, M.D., a neurosurgeon recently relocated to Salem from Loyola University Medical Center in Chicago. Also at the forum, a panel of physicians will discuss the disease and related issues.

Thursday, Sept. 21, 7-8:30 p.m. Call 503-561-5639 to register.

Visit Health Source, our online encyclopedia of medical information, at www.salemhospital.org/healthsource, to learn more about spine health and osteoporosis.