What is a Spinal compression fracture?

• Spinal compression fracture, also known as vertebral fracture, osteoporotic fracture, or wedge fracture, is a type of fracture in the spine typically caused by osteoporosis. Cancer spread to the spine can also lead to this type of fracture.
• These fractures are associated with sudden back pain which can lead to chronic pain, deformity, and loss of height.
• These fractures are very common and occur in approximately 700,000 people in the United States annually. It is estimated that 25% of all postmenopausal women have had a vertebral compression fracture. Compression fractures should be suspected in anyone over 45 years old with sudden back pain. These fractures can occur after fairly routine activities that slightly strains or jars the back such as lifting a bag of groceries or bending to pick something up off the floor. It can also occur suddenly or with falls.

Vertebral Augmentation

 Vertebral augmentation, also known as vertebroplasty or kyphoplasty, is a minimally invasive procedure designed to reduce the pain and loss of function associated with spine compression fractures. Vertebral augmentation is typically performed under moderate sedation with the patient asleep but arousable. One of two small needles are advanced under advanced x-ray guidance into the fractured vertebral body. A special balloon may be used to lift up the fractured vertebrae to create increased space in the vertebral body. Medical cement-like material called polymethylmethacrylate (PMMA) is then injected through the inserted needles which causes pain relief, stabilizes the spine and may restore strength and height to the fractured vertebrae. Pain relief is immediate for some patients and most patients see improvement within 48 hours.

These symptoms include: 

• • Sudden back pain
  • Worsening back pain with standing or walking
  • Easing of pain when lying down
  • Vertebral deformity – kyphosis
  • Height loss

If you are experiencing signs and symptoms of a spinal compression fracture and are finding it difficult to perform your daily activities and maintain your way of life, contact your primary care physician immediately. 

Is Vertebral Augmentation Right For Me?

You may be a candidate for Vertebral Augmentation if:  

• You are experiencing sudden back pain
• You are concerned about long-term consequences of spine compression fracture such as loss of height or vertebral deformity
• Do not want to wear back braces
• Your pain is not well controlled with pain killers

Key Advantages

Benefits

• Multiple research studies demonstrating symptomatic benefit of treatment with pain relief
• Reduce risk of long-term complications associated with spinal compression fractures
• Same day procedure
• No general anesthesia required

Risks

• Infection
• Allergic reaction to PMMA
• Spinal nerve or disc inflammation
• Disability from spinal cord injury – rare

Cement causing blockage of lung blood vessels – rare

Medications

Pain medications will help reduce symptoms of spinal compression fractures allowing the fractures to heal on their own. Does not lead to height restoration or reduce risk of vertebral deformity. They don’t always sufficiently control the pain.

Back bracing

Provides external support to limit motion of fractured vertebrae. Does not allow for immediate pain relief or height restoration. Risk of vertebral deformity in long-term.

Spinal fusion surgery

Surgery under general anesthesia where two or more vertebrae are fixed together to keep them from moving until they have a chance to fuse with each other. After an incision is made, metal screws are placed into the vertebrae. The screws are attached to metal plates or rods that are bolted together in the back of the spine. This is often used as the last resort therapy if other treatments fail.

Knee Osteoarthritis

What is Knee Osteoarthritis?

• Arthritis is a general term for joint inflammation. Osteoarthritis is the most common type of arthritis. It often comes with aging and most commonly affects the hands, knees, and hips.

Who is at risk?

• Increased age
• Increased weight
• Trauma to joint due to repetitive movements such as squatting or kneeling

What does the research say?

• Embolization for knee osteoarthritis (geniculate artery embolization) is successful in decreasing pain and improving function for patients with knee osteoarthritis

Genicular Artery Embolization Treatment

Genicular artery embolization (GAE) uses a small catheter passed through a vessel in the wrist or through a pin-hole sized hole in the groin. Using specialized imaging technology, the catheter is positioned in the genicular artery branches (vessels supplying blood flow to the knee joint) causing the pain and blocked off using small medical beads which leads to decreased inflammation of the joint. The entire treatment lasts about 1 hour and is an outpatient procedure.

Genicular artery embolization (GAE) has been demonstrated in multiple studies to decrease pain and improve function for the majority of treated patients with knee osteoarthritis.

Other Treatment Options

Surgical Treatments

Knee replacement

Medical Treatments

Pain killers and anti-inflammatory medications

Hot/cold packs

Knee joint steroid or stem cell injections

Assistive Devices

Canes, splints, walkers