New technique helps osteoporosis patients. (An Advertising Supplement to the San Fernando Valley Business Journal).

A minimally invasive, Medicare-approved medical procedure is proving highly successful in preventing pain and restoring mobility to those with spinal fractures related to osteoporosis. The procedure is called vertebroplasty. Because of its success, it is rapidly being adopted by surgeons across the country who find that it can resolve severe pain and suffering with a procedure performed in a matter of minutes.

When it comes to treating osteoporosis, prevention is still considered the first line f defense. The healthcare community now regularly urges those in their 40s and 50s to take steps to prevent osteoporosis through lifestyle improvements in diet supplementation and exercise. Hormone replacement therapy has been proven to offset calcium density loss related to menopause. Medications to increase bone density are available and regular bone density exams can determine if treatment is working.

Despite the progress in prevention and early treatment, however, osteoporosis has reached epidemic proportions in the U.S. With an aging population, the incidence of osteoporosis will double in the next 40 years. Incidence of the disease is much higher for women in their 50s and 60s in the years following menopause. Risk peaks for those between the ages of 70 and 80, when the incidence of the disease among men catches up with women. Currently, it's the cause of 1.2 million bone fractures each year. Of these, 700,000 are fractures of the spine. In the past, little could be done to treat these fractures.

According to Farzad Massoudi, M.D., Associate Clinical Professor of Neurosurgery at the UCLA School of Medicine, and principal of the Massoudi Neurosurgical Medical Group in Laguna Hills, California, the treatment of choice in the past was "benign neglect."

"More than 80 percent of these fractures will heal themselves over a period of many months, and our first course of action is still to see whether the fracture will improve, more or less, by itself," he said.

Dr. Massoudi explained that the challenge of conservative treatment is to make the patient comfortable while the fracture heals. Braces help to stabilize the fracture, but are uncomfortable to wear. Because the individual is not able to move as before, muscular degeneration frequently results, which can lead to rapid decline of the overall condition of a senior person. Blood clots frequently occur. Medications to reduce inflammation and to manage pain have other side effects, including dependence and habituation to the painkillers, constipation, cognitive memory loss. And despite the use of painkillers, the individuals still suffer from varying degrees of pain.

Invasive spinal surgery has been another option in the past, but it was expensive, could only benefit a small number of people and invited other complications.

By contrast, vertebroplasty offers an alternative that works quickly and has minimal risk. It's a treatment designed for when fractures occur in the middle and lower spine, which are the heaviest bones of the spinal column and the ones that bear most of the upper body's weight. Fractures occur due to osteoporosis' weakening of bone material, which then causes the vertebra to collapse. The procedure provides an internal brace for the vertebra by injecting a cushion of medical grade liquid cement into the area where osteoporosis has caused the loss of bone density. The cement takes the place of the lost bone material and hardens within minutes. Pain is diminished because the newly strengthened vertebra no longer irritates nearby nerves.

The surgeon performing vertebroplasty is guided by a live x-ray machine that allows exact placement of a tube through a small incision into the vertebra. The bone cement is injected through the tube and is then removed. The cement immediately begins to harden. The incision requires no more than a couple of stitches to close -- making it minimally invasive and less a burden on the patient. The entire procedure takes no more than 30 minutes per vertebrae. Often more than one vertebra is treated at the same time.

But who is a candidate for vertebroplasty? Symptoms of these fractures are a sudden onset of pain that is worse when standing or walking. If conservative medical treatment does not produce significant reduction of symptoms within a month, a person will be referred to a spine specialist. Diagnostic tests would be performed, including x-rays, CT scan and MRI to determine if a fracture is the cause, as opposed to other conditions such as scoliosis, and the exact location of the fracture.

According to Dr. Massoudi, "Outcomes are very good. Upwards of 90 percent of patients report significant or complete resolution of pain within a few hours or a few days of the surgery."

Janet Wall is a free-lance writer specializing in health related issues.