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The province is worried about the number of OHIP dollars flowing out of the province to pay for treatments elsewhere. A new cancer treatment helps ease pain that spreads to the bones.

Cement offers quicker fix for fractured vertebrae

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Canadian doctors are involved in a new study that has found a way to help cancer patients whose disease has spread to their bones.
Canada AM: Dr. Roger Smith, physician and Sharon Langley, patient
A new study suggests that an innovative procedure called balloon kyphoplasty provides significant relief and improves mobility in patients suffering from painful spine fractures. A doctor and a patient discuss the promising treatment.

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The province is worried about the number of OHIP dollars flowing out of the province to pay for treatments elsewhere. A new cancer treatment helps ease pain that spreads to the bones.

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The province is worried about the number of OHIP dollars flowing out of the province to pay for treatments elsewhere.

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Date: Thu. Mar. 17 2011 4:17 PM ET

For osteoporosis sufferers who suffer spinal fractures, the pain can be intense, leaving them unable to do even the simplest of tasks.

But now, a new study suggests an innovative procedure called balloon kyphoplasty can help sufferers restore movement.

As many as 65 per cent of spinal fractures caused by osteoporosis go undetected, dismissed by both patients and their doctors as simple back pain or arthritis.

But left untreated, fractures can cause the spine to shorten and angle forward, resulting in a hunched back, called "kyphosis," a condition that makes it difficult to walk and move about.

Balloon kyphoplasty offers hope. The procedure involves inserting a hollow tube inside the fractured vertebra bone, where a tiny balloon within the tube inflated.

The balloon helps to elevate the fractured bone back into place. It also creates a cavity within the vertebra, which is then filled with orthopedic acrylic cement. The cement acts as an internal cast that holds the vertebra in place, holding the corrected height of the vertebra while the bone heals.

Kyphoplasty is performed while the patient is awake, using a local anesthetic.

Its proponents say that not only can it help those with osteoporosis, it can also help those with fractures resulting from cancer or chemotherapy-induced brittle bones.

Sharon Langley underwent the procedure after she suffered vertebral compression fracture. One of the medications she was taking led to bone loss and osteoporosis. She'd already recovered from two spinal fracture from falls when her spine cracked while she was moving about her home.

"I was moving clothes from one closet to another and just moving hangers on the rack," she told CTV's Canada AM earlier this week.

She felt a crunch and then the pain, which lasted for weeks.

"I was in tremendous pain in my back and around my ribs. I couldn't do much at all. I couldn't do regular things around the house. Because I was tipped over a little bit, my balance was terrible and I was fearful of falling," she says.

Dr. Roger Smith, an interventional neuroradiologist at Toronto's University Health Network, performed the minimally invasive surgery on Langley. She says the pain relief was immediate.

"When I left the recovery area, I was straight. I had been tipped over with this fracture and I was straight. And the pain was much reduced," she says.

A study of the procedure was recently published in The Lancet. It involved 134 patients, including 26 from Canada with vertebral compression fractures and various types of cancer such as breast, lung, and prostate, or multiple myeloma.

The study showed that cancer patients treated with kyphoplasty had better back-specific function, more rapid back pain relief, and improved quality of life compared with non-surgical care one month after treatment.

The improvements in back-specific function, quality of life and back pain experienced by the kyphoplasty patients were sustained over the 12-month study.

The study was paid for by Medtronic Inc., which designed the equipment used in Kyphon Balloon Kyphoplasty.

A similar procedure has already been available, called vertebroplasty, though it has not always met with success. The researchers on this study say vertebroplasty is somewhat different in that it doesn't use the balloon to create the cavity in the bone and restore the height in the vertebra before the cement is added.

Not all patients are candidates for kyphoplasty, Smith says, which carries some risks. There have been reports of inflammation of the vertebra (called spondylitis), and in rare cases, the cement has migrated from the bone.

But for Langley, she says it gave her an alternative to weeks or months of pain and inactivity.

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