Time to stop bending

SECOND CHANCE

Time to stop bending

 If you did neglect a calcium-rich diet and fell prey to osteoporosis, the latest technological advances are here to help you lead a better life, writes Dr Manoj Miglani.

Has persistent back pain been hampering your daily activities lately? Are you compelled to lie down several times a day to give rest to your aching back? If yes, then you are not alone. Like many people across the world, you may be suffering from multiple spinal or vertebral compression fractures due to osteoporosis. 

Fractures caused by osteoporosis most often occur in the spine, with 7,00,000 people getting affected annually. The International Osteoporosis Foundation states that one in three women and one in five men over the age of 50 will experience osteoporotic fractures, globally. It is time to put the spotlight on the increasing prevalence of osteoporotic spinal fractures and efficacy of minimal access surgeries for their treatment.

Osteoporosis is a disease characterised by low bone mass and increased bone fragility. Unfortunately, osteoporosis often develops unnoticed over many years with no symptoms until a bone breaks. When the small bones of the spine (vertebrae) weaken from osteoporosis, they contract. This often leads to a rounded back, a hump or a curved look to the spine, making it susceptible to fracture. There is a pressing need to create awareness amongst people about spinal fractures, their treatment and measures to prevent recurrence.

Vertebral compression fracture is directly linked with low bone mass density and spine fractures. It occurs when osteoporosis weakens the spinal bones to the point that they crack and compress, leading to a stooped gait, a condition termed as Kyphosis.

Over time, multiple fractures may result in significant loss of height. The rib cage presses down on the pelvis, reducing thoracic and abdominal space. In severe cases, multiple vertebral compression fractures result in impaired pulmonary function, a protuberant abdomen, and because of compressed abdominal organs, early satiety and weight loss.

The most common symptom of a vertebral compression fracture is back pain. The pain typically occurs near the break itself. The pain often gets worse with standing or sitting for a period of time, and is relieved by rest or lying down. While adequate rest and medications may provide relief for a short period of time, in cases where the patient is in severe pain, surgical intervention is recommended.

Cutting edge

Spinal bones which have already collapsed cannot be mended with medications and calls for surgery. Fortunately, with the advent of medically-advanced technologies like Balloon Kyphoplasty, spine surgeries have become less intricate, safe and effective with minimal side-effects.

Balloon Kyphoplasty is a minimally invasive procedure, which treats spine fractures giving absolute relief from the problem. The procedure is called so because orthopaedic balloons are used to lift the fractured bone and return it to the correct position.

In this process, typically, two balloons are used, one on each side of the vertebral column, to  support the bone in a better way as it moves back into position and increase the likelihood of deformity correction. Next, the balloons are carefully inflated to raise the collapsed vertebral body and return it to its correct anatomical position.

Inflation of the balloons moves the soft, inner bone against the wall of the vertebral body, creating a cavity (space) inside the vertebra. Bone cement is then deposited into the cavity to stabilise the fracture.

Once the vertebral body is in the correct position, the balloons are deflated and removed. The cavity is filled with thick bone cement to stabilise the fracture. The bone cement forms an internal cast that holds the vertebral body in place. Pre-procedure preparation includes diagnostic tests such as X-ray to determine the precise location of the fracture.

It would be of interest for people to know that minimal access spine surgeries or less invasive spine surgeries like Balloon Kyphoplasty are safer and more patient friendly than open surgeries, allowing surgeons to operate without the risk of injury to the spine and adjoining muscles.

In fact, Balloon Kyphoplasty is one of the most advanced and safest surgical options for spinal fractures, associated with lesser blood loss, shorter hospitalisation and faster recovery.

So, while a high calcium diet and healthy lifestyle are important to avert osteoporosis and prevent multiple fractures, innovative cutting-edge technologies to treat spinal fractures have improved the quality of life of people, giving them a reason to rejoice.

(The author is orthopaedic spine surgeon, Fortis Hospital, Delhi)

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