Minimally invasive breakthrough treatment For (BPH) Benign Prostatic Hyperplasia
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Despite recent advances in medical therapy for osteoporosis, osteoporotic vertebral fractures remain a common problem of patients. Osteoporotic vertebral compressions usually remain sub clinical
and progress gradually; however, some patients develop an acute
severe pain syndrome with limited mobility and functional deterioration.
Traditional treatment included bed rest, analgesics, muscle relaxants,
external back bracing and physical therapy. The majority of patients
respond favorably to traditional treatment; however, there are
some patients who fail with conservative therapy and suffer from
prolonged pain and immobility, which can persist for life. Complications
of vertebral compression fractures include the following: deep
venous thrombosis; acceleration of osteoporosis; loss of height;
respiratory or gastrointestinal disturbances; and emotional and
social problems secondary to unremitting pain and loss of independence.
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Percutaneous vertebroplasty is a newer non-surgical technique
in which a medical grade cement is injected though a needle into
a painful fractured vertebral body. This stabilizes the fracture,
allowing most patients to discontinue or significantly decrease
analgesics and resume normal activity. Patients who are unresponsive
to conservative therapy of bed rest, analgesics, and back bracing
should be considered for vertebroplasty. Vertebroplasty is also
useful in painful or unstable benign and malignant vertebral lesions
that fail to respond to the traditional conservative therapies. The procedure is performed while the patient is awake but sedated, and lying facedown so the interventional radiologist has access to the back. The back is numbed by a local anesthetic, the procedure is performed by an interventional neuroradiologist — a physician with special expertise in the nerves, brain and spinal cord. Through a small incision and guided by a fluoroscope, the neuroradiologist passes a hollow needle through the spinal muscles and into the fractured vertebra. X-ray cameras above, below and on the sides of the table provide guidance for needle placement. When the needle is in the correct position, bone cement is injected through the needle into the vertebra. As a rule, the procedure takes one hour for each vertebra that is treated. After the procedure, patients lie flat on their backs for two
hours while the cement hardens. They are then discharged and can
resume normal activity. The majority of patients have significant
pain relief within a few days. Indications for Percutaneous Vertebroplasty 1. Osteoporotic vertebral compression fractures causing moderate
to severe pain. Advantages of Vertebroplasty 1. Decreased pain. Vertebroplasty reduces and in some cases eliminates the need for pain medication, and it also restores mobility in many patients. 2. Increased functional abilities. Vertebroplasty stabilizes the fracture, decreases pain dramatically and allows a return to the previous level of activity. 3. Prevention of further vertebral collapse. The cement fills spaces in bones made porous by osteoporosis, strengthening the bone so that it is less likely to fracture again.
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