Almost all of us will suffer from back pain at some point. However, for a significant minority the pain is not just a few weeks after lifting something a bit too heavy but an unrelenting and seemingly endless pain that no amount of drugs can fix. Millions of Americans suffer from this each year and some estimates suggest that a whopping 10% of the population have chronic back pain. In fact, it is the second most common disability in the United States of America and represents the most common reason to take sick leave. For years, opioid medications like codeine and morphine have been relied on. But with the recent crackdown following the opioid epidemic, many Americans have been left suffering in silence desperate for a route out. For some, the pain is caused by a compression fracture that can be treated by a surgical procedure known as a vertebroplasty. Until now there was little data to suggest that this was any better than conservative pain medications, however, a recent study published in a large international journal might change that wisdom.
What is a compression fracture?
A compression fracture is often defined as a backbone that has decreased in height by around 15-20%. These bones in your back keep the curvature of your back and protect the spinal cord that carries signals up from the body into the brain. When these discs, known as vertebrae are squashed for long periods of time they can shrink. This can often result in pain. There are a number of diseases that can cause a compression fracture, the most common in older people being osteoporosis. In younger people, they might be caused by trauma or metastatic cancer.
What is a vertebroplasty?
In a vertebroplasty, a surgeon injects a cement-like material into the bone – increasing its size. A kyphoplasty is a similar procedure where a balloon is inserted before the cement is injected.
So is a vertebroplasty worth it?
Well, all surgery has risks of complications – and this one is no different. Once you are assessed as fit for the surgery it may be worth taking some time to think about whether you would like to go ahead as complication is unlikely but can occur. The other thing to think about is if the surgery is better than conservative treatment. A new meta-analysis (a study where lots of trials and studies are combined into one massive study) suggests vertebroplasty is better than conservative treatment. The authors, who published their paper in the International Journal of Surgery, concluded
“[Vertebroplasty] is associated with higher pain relief than CT in the early period. Furthermore, [vertebroplasty] did not increase the rate of adjacent vertebral fracture. The results indicate that it is a safe and effective treatment…”
The study included data from 13 reports that included some 1231 patients. 608 of these patients had the conservative therapy whilst 623 underwent the surgery.
If you or somebody you know is interested in surgery for their back pain – get in contact with one of the specialized spine centers across the country which provide this procedure.