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Saint Barnabas Orthopedic Surgeons are the Only New Jersey Physicians Trained in New Surgery for Vertebral Fractures LIVINGSTON, NJ -- Saint Barnabas Medical Center is one of only 20 sites in the nation and the only institution in New Jersey currently participating in a revolutionary study of a minimally invasive technique for treating vertebral compression fractures (VCF) due to osteoporosis. As the investigators for a clinical outcome study for Kyphon Inc., an orthopedic medical device company, orthopedic surgeons Casey Lee, M.D., and Kenneth Kopacz, M.D., have been performing Kyphoplasty™, a new type of spinal surgery. The procedure uses a small, inflated balloon to elevate the collapsed vertebral bone and realign the spinal column. “So far the experience of our patients has been completely positive,” says Dr. Lee, who has performed the procedure four times since March, which marked the beginning of the two-month surgical portion of the study. “It is a very minimally invasive procedure and they feel so wonderful when they wake up. In the past it would have taken several painful months for this kind injury to heal. Also, with the new procedure, there is almost no chance of rebreaking the same vertebral bone.” Through Kyphoplasty™, relief may be in sight for the estimated 700,000 people who suffer from vertebral compression fractures caused by osteoporosis each year. When a vertebral bone fracture occurs, it causes portions of one of the 24 bones in the back to collapse. The break leads to loss of height and forces the spinal column to curve forward, creating a deformity of the spine called “kyphosis” or a “Dowager’s hump.” According to a 1999 study published in the Archives of Internal Medicine, long-term effects of VCF can include chronic pain, impaired function, increased risk of future fractures, decreased pulmonary function and increased lung disease. The mechanics of the procedure involve a surgeon making a small incision in the skin, then drilling a path down and into the fractured vertebral body. While the physician monitors the situation by X-ray, a small balloon is inserted through the tiny hole and into the fractured vertebra. As it inflates inside the bone, the balloon elevates and expands the collapsed vertebra back toward its normal position. Once the balloon is removed, the remaining cavity left behind is filled with bone cement to create an “internal cast.” This cast fixes the fracture, keeps it in place and prevents further collapse of the treated vertebral body. According to Kyphon Inc., this procedure is designed to reduce or eliminate pain and restore some or all of the normal vertebral body anatomy by straightening the spine for those with recent spine fractures. To date, over 150 VCFs have been treated in over 80 patients and pain relief has been reported in 90 percent of them, with the longest follow-up patient studied 12 months after the procedure. Kyphon Inc. currently reports a zero failure rate and has found the procedure to be well tolerated overall. While the Kyphoplasty™ has been approved by the Food and Drug Administration, Kyphon Inc. is allowing only limited use of the technology until compilation of the statistical data. As compared to conventional medical therapy or surgical treatment, Kyphoplasty™ is a minimally invasive procedure with a short operative and outpatient time and use of local or general anesthesia. It provides immediate pain relief and a shortened time to resume daily activities, and is reported to stabilize the vertebral fracture, reduce spinal deformity and restore vertebrate body height. In the past, the most common treatment for VCFs has included pain medication and keeping the patient still through bedrest. Dr. Lee reports that neither of these method proved especially effective, and inactivity sometimes caused further softening and deterioration of the bones during the healing process. In addition, major spinal surgery was ruled out in most cases because the softness of the bone would cause it to slip out of place again. “This problem has been so frustrating to treat because we have not had a good way of helping these patients,” reports Dr. Lee. “For that reason, a number of these people have been taking pain medication and not seeking further treatment with a specialist. Now, with the help of the new procedure, we may see an increase in new patients coming forward.” Celia Skowronski of Bayonne was the first of Dr. Lee’s study patients to have the procedure done and she would “recommend it highly” to those suffering from the same condition. Ms. Skowronski first heard that a physician in Baltimore, Md., was performing the procedure and she quickly searched for a New Jersey-based orthopedic surgeon in the same study. An injury to her vertebral bone had left her with excruciating back pain and prompted her search for a cure. “I figured if they can put a man on the moon they should be able to find a way to help me,” says Ms. Skowronski. “If I had to do it again I would have the procedure done in a minute. It has made a big difference in the way I feel. I’ve spoken to other people who are thinking about having it done and I say, ‘What are you waiting for?" H. Mahmood Cheema, M.D., Section Chief for Orthopedic Surgery in the Department of Surgery at Saint Barnabas relates that this particular procedure is not for all patients, but rather for a select group. For this group, however, he believes that “the long-term results will be very promising.” While Kyphoplasty™ may provide much needed help to patients with VCFs, the treatment of broken fractures does not prevent future breaks in other areas of the spine due to the ravages of osteoporosis. For this reason, Drs. Lee and Kopacz are referring all of their patients to The Osteoporosis and Metabolic Bone Disease Center at Saint Barnabas Ambulatory Care Center. “This procedure greatly reduces pain and is a valuable treatment, but it does not address the underlying disease,” cautions Marjorie Luckey, M.D., Medical Director of the Osteoporosis Center. “Unfortunately, a spine fracture usually indicates severe osteoporosis. If left untreated, further deterioration and more fractures are likely. Once you have one spine fracture, you are at least 25 times more likely to have another. You are also at risk for fractures in other areas, such as the hips, arms and wrists. Treatment for osteoporosis is critical to reduce the risks.” Dr. Luckey reports that osteoporosis treatment can reduce the risk of having a broken bone by 50 percent. At The Osteoporosis and Metabolic Bone Disease Center, patients receive advanced diagnostic care, including sophisticated bone imaging technology, consultation with a multidisciplinary team of specialists and customized treatment plans that often include exercise and nutritional counseling as well as effective medicine. For more information about Kyphoplasty™, please contact the Vertebral Body Compression Fracture Study, through Drs. Lee and Kopacz, at (973) 226-2725. To contact The Osteoporosis and Metabolic Bone Disease Center, please call (973) 322-7430. For a referral to a Saint Barnabas physician, please call –1-888-SBMC-DOC. [ top ] |
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