| June 12, 2000
HUP Offers Vertebroplasty -- A Minimally Invasive
Procedure to Stabilize Compression Fractures of the
Spine
(Philadelphia, PA) -- The Hospital of the University
of Pennsylvania is the only hospital in the Delaware
Valley and one of only a few around the nation using
a novel procedure called vertebroplasty that gives patients
relief from painful compressed spinal fractures. Using
sophisticated imaging technology, highly-skilled radiologists
inject medicinal liquid cement into the compressed fracture
stabilizing the brittle bone, preventing further compression,
and alleviating back pain. Compression fractures of
the spine can be caused by traumas such as car accidents
or falls. Likewise, compression fractures are often
the result of severe osteoporosis, which can cause such
debilitating pain that walking, eating and even breathing
becomes labored and difficult. Some women with extreme
cases even become bedridden or wheelchair bound and
conventional methods of relieving this pain include
wearing uncomfortable back braces or taking oral pain
medications. "Vertebroplasty is an exciting new technique
that will help many individuals return to their normal
daily living activities," says Steven G. Imbesi, MD,
assistant professor of radiology. "Studies have shown
that 90 percent of patients who undergo this procedure
experience immediate pain relief." Prior to the procedure,
the physician reviews the patient's spinal X-ray, MRI,
and bone scan to pinpoint the exact location of the
compressed vertebra. These images help determine if
the compression fracture is the primary cause of pain
and whether any nerve damage is involved. During the
surgery, which takes a few hours, the patient lies on
his/her stomach while the radiologist uses a fluoroscope--
an active X-ray machine-- to get a detailed image of
the skeletal spine. Under general anesthesia, the patient
is injected with a contrast dye to insure proper localization
of the needle and solution. With accurate precision
using sophisticated imaging technology, the radiologist
injects liquid cement, clinically called methyl methacrylate,
directly into the patient's brittle bone stabilizing
the fracture and preventing further compression. "The
liquid cement is the same substance that has been used
by orthopaedic surgeons to repair bone fractures," says
Dr. Imbesi. "This is a new way of delivering the cement
to such an intricate area. Since we are so close to
the spinal cord, it's critical that this procedure is
performed by a trained radiologist who can accurately
read the images and closely monitor the position of
the needle and the level of cement being injected,"
he explains. The medical cement fills in the brittle
areas of the bone and solidifies in about 20 minutes.
Patients are hospitalized overnight and experience pain
relief as early as the next day. "Patients feel so much
better after surgery that it is necessary to remind
them to take it easy and gradually get back into their
normal living activities," explains Dr. Imbesi. This
technique is only applicable for individuals who have
had their diagnosis within three to 12 months of the
compression fracture and for those whose compression
fracture is specifically located within the T5 (thoracic
or mid-back) through L5 (lumbar region or lower back)
vertebrae. In addition, patients must first try conventional
therapy for at least two months before being eligible
for vertebroplasty.
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Editor's note: Dr. Imbesi is available for interview
and can be reached by calling Sue Montgomery in the
Public Affairs office at 215-349-5657.
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