Vertebral compressions fractures, (VCFs), are a serious problem for older Americans. Approximately 700,000 VCFs occur each year, equating to a staggering 40 VCFs every thirty minutes. For patients with a vertebral fracture, Dr. Fabian A. Ramos will be able, in most of the cases, to relieve or significantly reduce pain by performing a vertebral augmentation kyphoplasty or a vertebroplasty.
Fragility fractures are a serious and growing problem for older adults and the healthcare system. In fact, 50% of women and 25% of men will have an osteoporotic fracture in their lifetime. The annual direct medical cost is estimated at $746 million.
Vertebral Fracture Treatment
Vertebral Augmentation, Balloon Augmentation or Kyphoplasty Balloon
Dr. Ramos has been using the iVAS Inflatable Vertebral Augmentation System successfully during the recent years. The equipment used is part of an unparalleled portfolio of mixer and delivery systems, bone cements, needles, and cavity formation devices. During this type of vertebral augmentation, a balloon catheter is used to pneumatically push and compact the bone inside the fractured vertebra, creating a void in the collapsed vertebra to help and allow for controlled and contained cement delivery. The cement (bioactive resin) also flows to interdigitate inside the trabeculae and once hardened, the cement creates an internal cast that stabilizes the fracture, thereby reliably alleviating pain in approximately ninety percent of patients*.
Vertebroplasty offers a proven treatment that assures quality results for patients and the healthcare system alike. This minimally invasive, image-guided treatment, in which bone cement is injected into the vertebral body, significantly decreases pain and increases mobility in more than 90 percent of patients.
In this type of procedure, the cement is injected without the previous creation of a cavity and the delivery of cement is less contained compared to the balloon technique. All augmentation techniques produce stabilization of the vertebral fracture and help protect against further collapse of the treated vertebra, thereby preventing further kyphosis commonly seen as a result of severely wedged progressive fractures. The development of a kyphotic wedge collapse will shift the center of gravity forward to the anterior third of the vertebral bodies above and below the fractured level(s), therefore increasing the incidence of future fractures, especially in osteoporosis.
Many times, a vertebral fracture is not symptomatic and the patient will develop more fractures in the future that will show incidentally in random x-rays. The injection of cement significantly improves pain and function but does not reduce the risk of more fractures in the future. Especially if the fracture is already wedged prior to the treatment. Treating the fracture early in the presentation may prevent this trend. Approximately 90% of patients with vertebral compression fractures (VCFs) who do not respond to conservative treatment or who continue to have severe pain will benefit from Vertebral Augmentation techniques. VCFs may be caused by osteoporosis, spinal tumors, multiple myeloma, and metastatic bone disease.
Vertebroplasty was first performed in France in 1984 and has been widely used in the United States since the mid-1990s. It is performed on an outpatient basis under local anesthesia and mild sedation, saving patients and insurers the greater cost of overnight hospital stays.