THE KYPHOPLASTY OPTION
A minimally invasive approach to healing spinal fractures
Are you OK?” someone asked as she crouched by me on the freshly varnished floor. “I don’t know,” I replied, rolling to my side. “Let me see if I can move my legs.” I was petrified. It was a hard fall, the hardest I’d ever taken. There was nothing to hold onto, nothing to lessen the blow.
I could, indeed, move my legs, but I couldn’t breathe well, something I later learned happens when you torque your thoracic spine. Your innards are supposed to stay in place in your rib cage, not get slogged around the way they do when you have a blunt force trauma from an accident, or, in my case, a fall. In a few days I was able to breathe deeply again, but the back injury plagued me.
A month later, when I couldn’t bear to chop a carrot for my kids’ dinner or write a feature story without having to lie down on ice, I went in for an MRI and requested physical therapy. The pain was not necessarily grueling. First thing in the morning it didn’t hurt t oo much, just like someone had a fist in my back. By mid-morning, though, I was ready for ibuprofen for brunch and every four hours for the rest of the day. By the end of the day, the pain was debilitating, and I spent every evening with my new best friend, the ice pack.
I expected the MRI to be normal. But the doctor entered the room and announced almost glibly, “Well, we know why you’re in pain. You broke your back.”
Technically, the diagnosis was a T8 wedge compression fracture with 50 percent height loss. And that’s when I first heard the word kyphoplasty.
After the requisite visit to a neurologist and the onset of physical therapy, I was referred to Dr. Michael Frey at Advanced Pain Management and Spine Specialists in Fort Myers. I won’t go near anything with “oxy” as a prefix, but Dr. Frey told me kyphoplasty was an option, and that it’s something he’s pretty well known for. I watched a video on the procedure and took home some literature. I could live with this injury, ice and ibuprofen for the rest of my life, or I could take a shot at feeling “at least 75 percent better,” as the doctor promised.
Kyphoplasty is probably the most minimally invasive of spinal procedures. Under guided imagery, with the patient under sedation, a hollow needle is inserted through the skin into the area of compression. A balloon is inflated to bring the compressed vertebra to its normal height, and bone cement (polymethylmethacrylate) is injected to correct the compression.
Post-op, the injection site was literally a dot on my back. The major inconvenience was that bending, twisting and lifting were not allowed for two weeks as the cement set. A month after kyphoplasty, I restarted physical therapy—and my back is much more than that 75 percent better than the doctor promised. It’s almost “back” to normal.
An untreated compression fracture (left) may not have obvious symptoms. Kyphoplasty (pictured) is performed by inserting a hollow needle through the skin, inflating the area. Bone cement is then injected to correct the compression.