I started vertebroplasty.

What is a compression fracture?

The vertebrae are naturally strong bones, and unless a healthy person receives a fairly strong impact such as falling from a height, a fracture will not occur. However, if the bones become thin due to osteoporosis or if there is a tumor, even a slight stimulus such as a slight bump or sneeze can cause a fracture. If a fracture causes pressure on nerves, surgery may be required, but in many cases, pain is the biggest symptom, and conservative treatment such as rest and immobilization is performed. However, with conservative treatment, the pain may not be relieved, or the fracture may not heal, resulting in a condition called "pseudarthrosis," which is a major cause of a curved back (kyphosis). In addition, in some cases, elderly people may become bedridden after resting and immobilizing the patient, so it is of great significance to relieve pain early. In these cases, a new treatment called vertebroplasty is performed.

What is vertebroplasty?

It began to be performed in Europe and the United States in the 1980s, and is now performed on more than 100,000 patients every year. In Japan, up until now, treatment has been performed at a limited number of facilities as self-pay or highly advanced medical treatment, but it has finally become possible to receive medical treatment under insurance.  There are two methods: injecting bone cement directly into the vertebral body where the compression fracture occurred (percutaneous vertebroplasty (PVP)), and injecting bone cement into the space after inflating the fractured vertebral body with a balloon (Balloon Kyphoplasty BKP). ). It is said to be most suitable for cases in which pain cannot be relieved with conservative treatment, or in cases where the fracture has become pseudounion-like, but the final indication is determined based on symptoms and imaging tests such as CT and MRI. That's it. Bone cement injection is performed while checking with X-ray fluoroscopy and X-ray CT, but at our hospital we mainly use CT for confirmation. In over 90% of cases, this treatment significantly reduces pain, which is its biggest therapeutic benefit. The treatment takes about 1 to 2 hours.

What are the side effects and complications?

It can be caused by bone cement leaking out of the vertebral body, but the neurological symptoms such as numbness caused by a small amount of leakage are mostly temporary. Pulmonary embolism caused by cement flowing into blood vessels is also a complication, but serious complications that pose a clinical problem are rare. In foreign countries, cases of shock due to a reaction to the bone cement itself have been reported.

What is the cost?

Up until now, it had been performed as self-pay treatment or highly advanced medical treatment, but from April 2012, percutaneous vertebroplasty has become eligible for insurance treatment. The surgery fee is approximately 200,000 yen, but the actual cost is the amount that includes hospitalization fees, etc., and 10-30% of this will be borne by the individual.

Vertebral body with compression fracture (MRI image)
(→ area)

X-ray image after PVP treatment
Bone cement is injected into the → area.