Washington Hospital Offers More Effective Treatment for Painful Spinal Fractures

When Dorothy Benya’s husband Robert slipped on the bathroom floor, she rushed to help him up. Married nearly 60 years, the Fremont couple is used to being there for each other.

“Looking back on it, I should have called 9-1-1, but I thought it would be faster and easier to do it myself,” recalled 82-year-old Dorothy, who is nearly a foot shorter than her husband.

Unfortunately, the quick decision didn’t turn out to be so easy and resulted in serious consequences for her own health.

“When I started pulling Robert up, I heard something snap in my lower back,” Dorothy related. “I was in instant agony.”

One of the vertebrae in Dorothy’s spine had cracked. Vertebral compression fractures, or VCFs, are cracks, fractures or collapses of the vertebra. In the U.S., more than 700,000 VCFs occur every year. The condition can be very painful and debilitating and is usually related to osteoporosis.

With osteoporosis, bones can become fragile and brittle, and it doesn’t take much to trigger a VCF. The injury can result from common movements like sitting down, reaching for something, missing a curb, or slipping on a wet surface. If not treated, the compression may get progressively worse and can severely limit a person’s ability to be active and independent. After one VCF, there is increased risk that more will occur.

“The vertebra is like a raw egg,” explained Dorothy’s neurosurgeon Sandeep Kunwar, MD, who practices with the Washington Township Medical Foundation. “When the egg shell is solid, it’s very strong and difficult to break by squeezing it. But, if even a small crack develops, it’s likely more cracks will occur, and it’s far easier to crush the egg.”

The majority of VCFs heal on their own over time. However, if the painful condition persists, it can be treated surgically to speed up healing, strengthen the bone and help prevent further fractures.

Experts estimate two-thirds of VCFs are never diagnosed because many people blame the resulting back pain on aging or arthritis. For others like Dorothy, the pain is so extreme they are compelled to seek medical care.

“VCF treatment has evolved over time,” reported Dr. Kunwar. “We treated Dorothy with a relatively new, minimally invasive procedure called the Kiva VCF Treatment System. It was amazing to see the significant reduction in her pain immediately after surgery.

“Most patients who have this procedure recover quickly,” he continued. “In fact, the major concern after surgery is that people will start doing things too quickly.”

Minimally invasive VCF treatments include vertebroplasty, in which bone cement is injected into the cracked vertebra. Another approach is balloon kyphoplasty, in which two needles are used to inflate a balloon to restore the height of the vertebra and inject bone cement into the space. Studies have shown these procedures relieve pain successfully, but have been less effective in preventing further fractures.

Kiva takes a different approach. During this outpatient procedure, the surgeon inserts a single needle into the compressed vertebra and uses a coiling device to create a 3-dimensional cage that opens up the bone. Then, the cage is filled with cement. This permanent structure keeps the vertebra from collapsing again.

“Kiva has taken VCF treatment to the next level,” added Dr. Kunwar. “The results have been studied more closely and systematically than any other approach. Pain relief has been just as effective, and there has been significantly less likelihood of additional VCFs.”

For Dorothy, having the Kiva procedure has made all the difference. Three months after her surgery she has some mild pain in her back, especially when she gets tired, but it is tolerable and doesn’t get close to the extreme pain she experienced after her injury. She is not taking any pain medication.

“I have to limit the time I work in my garden to avoid getting tired, but I’m hopeful I’ll be able to resume my usual activities, including tap dancing with the local Fremont Tappers, by next fall,” Dorothy predicted.

“But, as much I love my husband, I will never try to pick him up again.”

Learn more.

To learn more about the Neuroscience Institute at Washington Hospital, go to www.whhs.com. For more information about Washington Township Medical Foundation, visit www.mywtmf.com.