Vertebral compression fractures (VCFs) are fairly common in older populations. They can cause intense pain severe enough to be debilitating. Pain can be addressed through a variety of means including prescription painkillers, injection therapies, and a procedure known as kyphoplasty. A University of Pennsylvania study published in early 2024 promotes kyphoplasty as a means of providing effective pain relief while also reducing opioid consumption.
Opioid prescriptions represent one of the more common ways to address VCF pain. But long-term opioid use is not recommended. Here is the thing: VCF pain tends to be chronic pain. It lingers month after month because VCF is permanent. However, kyphoplasty can reverse the condition and thereby eliminate pain.
More About VCFs
Also known more simply as compression fractures, VCFs are the result of weakened vertebrae that can no longer support the weight they are designed to bear. They collapse under that weight. This causes spinal compression which, in turn, results in compressed nerves. That is where the pain associated with compression fractures arises from.
Additional pain can be felt in the vertebrae itself. But whether pain is strictly from compressed nerves or a combination of nerve and bone compression, the best solution is to deal with the compression itself. Kyphoplasty does just that.
How Kyphoplasty Works
While kyphoplasty might require a tremendous amount of skill and knowledge to pull off, it is fairly easy to understand. The procedure is designed to reverse a compression fracture by expanding the bone and then supporting it with another material.
The procedure starts with a local anesthetic and the insertion of a tiny balloon in the affected vertebrae. The balloon is slowly inflated until the compressed vertebrae is back to normal size. It is then removed and replaced immediately with bone cement. The cement fills the space, hardens, and creates a permanent structure to support the vertebrae.
Kyphoplasty is intended to be a permanent solution to a very serious fracture. There are risks involved, including the possibility that leaking bone cement might cause pain in neighboring tissue. However, the procedure is generally accepted as being a low-risk procedure.
Clinicians at Texas-based Lone Star Pain Medicine say that many patients undergoing kyphoplasty report immediate relief. Even when immediate relief is not experienced, most patients realize complete pain relief within a day or two.
The Opioid Issue
With an understanding of kyphoplasty, it is time to get back to the study this post opened with. Researchers studied the cases of twenty-seven patients experiencing VCFs between 2015 and 2023. Patients were between the ages of 50 and 85.
The primary objective was to measure opioid consumption among patients in the 90 days following kyphoplasty. It was compared to opioid consumption between the time of the original fracture and when the procedure was performed. Here is what the researchers discovered:
- 59% of the patients used prescription opioids prior to kyphoplasty.
- Total opioid consumption decreased following the procedure.
- Consumption frequency also decreased post-kyphoplasty.
- Patients using opioids prior to the procedure reported more pain.
- Both opioid and non-opioid users reported less pain following kyphoplasty.
The researchers concluded that kyphoplasty can be effective in helping VCF patients reduce their use of opioid painkillers. Their findings were consistent with previous studies that showed similar results. All in all, the data points to kyphoplasty as an effective means of relieving VCF pain.
As someone who believes we ought to be doing everything we can to reduce opioid prescriptions, I consider the results of this study very positive. If kyphoplasty can help VCF patients by keeping them off prescription medications, I am all for it.
