‘A Permanent Fix’

Relieve pain, regain height with treatment for spinal compression fractures.

The best camera money could buy was still producing grainy black-and-white images when William Keith began to bring the vast California countryside to life through his full-color realist and mystic style paintings.

Carrie Brewster posing for a photo inside her home with her dog.

Carrie is standing up straighter and walking with more confidence since undergoing a series of kyphoplasty procedures.

The largest collection of the artist’s work – 180 landscapes – now reside not far from where he painted them, at Saint Mary’s College Museum of Art near San Francisco, where Carrie Brewster spent 14 years as director.

“I got my start in the business running the art gallery at Santa Fe College in Gainesville, then moved to Guam, where I ran Isla Center for the Arts for the University of Guam,” Carrie explains. “After that, it was on to California, where I stayed until I retired in 2012.”

That was a momentous year for Carrie for reasons other than retirement. It was also a year ago she suffered two heart attacks and two strokes and was diagnosed with multiple myeloma, a cancer of plasma cells in blood that weakens bones.

There is no cure for multiple myeloma, but Carrie, who moved to Florida with her husband following their retirement, is proof that it can be managed to allow patients to live mostly normal lives.

Now 67, Carrie paints, sculpts and looks after her grandchildren when necessary. She also works regularly in her garden, although there have been times in recent years when back pain made a simple walk rather difficult.

“What multiple myeloma does is attack the bones, it eats away at them,” Carrie describes. “As a result, the vertebrae have started collapsing. That puts a lot of pressure on the nerves in my back, which causes a lot of pain.

“I’ve dealt with this for long enough now that I’ve learned how to tolerate the pain, but there were times when I’d be walking and my legs would collapse under me from the nerves pinching and all the pain. It felt like my legs couldn’t bear the weight of my body. When that would happen, the pain would usually hit me first at the base of my spine, then travel down my legs and cause
them to cramp up.

“The pain never bothered me when I was lying down or sitting or sleeping, which was good. But it hurt so much to walk that I was confined to a wheelchair for a while. And when I did walk, I was all hunched over, which I didn’t like.

“I’m one of those people who pushes themselves as far as they can, so I’ve fought through this, but I was talking to my primary care physician about all these problems awhile back, and she recommended a practice where I could get some help.”

The practice is Jax Spine & Pain Centers, which specializes in the use of progressive interventional treatment options to address chronic joint, neck and back pain.

Carrie first visited Jax Spine & Pain Centers this past January. She arrived bearing x-rays that showed her back pain was the result of a series of spinal compression fractures in which the bones in the spine weaken and collapse.

Drawing of a spinal cord displaying a Spinal Compression Fracture.

Spinal Compression Fracture

Spinal compression fractures can be triggered by something as simple as a sneeze or fall. However, osteoporosis, a condition that leads to loss of bone mass, is a leading cause of the fractures, which over time can result in sufferers losing height and walking hunched over.

In addition to multiple myeloma, Carrie suffers from osteoporosis, so when she first visited Jax Spine & Pain Centers, Hares Akbary, MD, was not surprised by what he saw on the x-rays. Thankfully, he had a remedy for her problem: kyphoplasty.

Painless Procedure

Kyphoplasty, (pronounced kifo-plastee) is a minimally invasive injection-like procedure that can be completed under light sedation in the offices of Jax Spine & Pain Centers.
“That’s one of the beauties of this procedure,” Dr. Akbary adds. “Many, many years ago, this procedure had to be done in an operating room. Now it can be done in an outpatient setting. And what’s really great about it is that it results in immediate pain relief.

“As a physician, it’s extremely rewarding to know that you are providing a patient with instant gratification because there aren’t a lot of procedures in medicine that do that. But with this procedure, patients typically feel phenomenal right afterward.

“The only post-procedure pain anyone might feel after a kyphoplasty is a little bit of muscle soreness, but that goes away quickly because in performing this procedure no stitches, sutures or staples are required.”

Kyphoplasty is performed through a small incision in the back through which the physician uses a needle and x-ray guidance to insert a balloon into the fractured vertebra. By inflating the balloon, the compressed vertebra returns to its original height.

The cavity that is created by the expansion of the balloon is filled with a fast-drying cement that immediately stabilizes the fracture, alleviating pressure on the nerves and eliminating the pain. The procedure takes about 30 minutes.

“Dr. Hanes an excellent doctor whom I trust completely, and I recommend him to anyone, because he’s a miracle worker.” – Mary Lou

“Another thing that’s great is that it’s a permanent fix,” adds Michael Hanes, MD, of Jax Spine & Pain Centers. “It prevents the vertebra that’s treated from ever fracturing again or losing more height, which is a critical aspect.

“When you see a man or woman in their 80s who’s all hunched over, it’s usually because they suffered a lot of spinal compression fractures that were never treated. This procedure can correct that problem, and it corrects it for good.”

At Jax Pain & Spine Centers, kyphoplasty procedures can be performed within 24 hours of a patient being diagnosed with a spinal fracture.
An additional benefit of having the treatment done in the office is that it is less costly.

“If you go to a hospital or surgery center, you’ll pay significantly more because you also need to pay professional and facility fees,” says Mike Bergantino, chief operating officer of Jax Spine & Pain Centers. “At our office, your regular office co-pay covers the cost.”

In treating spinal compression fracture patients, the doctors at Jax Spine & Pain Centers typically recommend kyphoplasty for two reasons. First, it alleviates pain. Second, it restores any height the patient may have lost as a result of the fractures.

“But there was a third reason why I recommended this procedure for Carrie, and that’s because she has multiple myeloma,” Dr. Akbary notes. “This procedure can help decrease the tumor burden on the bone because it strengthens and stabilizes the bone.

“And that’s important because once someone has suffered one compression fracture, they are at a five times greater risk for a second. And when you’ve had two fractures, your risk of having three or more becomes 12 times greater.”

Walking Tall

Carrie is proof those risks are real.

Mary Lou Beyreis sitting at the top of her patio stairs with her two dogs.

Mary Lou says her kyphoplasty treatment was “absolutely painless” and provided immediate pain relief.

Dr. Akbary found 12 spinal compression fractures on her x-ray. His plan for treating those fractures was kyphoplasty on each one – three vertebrae at a time.

“We treated her in multiple stages,” Dr. Akbary reports. “We did that four times, treating a different level each time, addressing the fractures as well as tumors that she has in the bone. Her last kyphoplasty was in early August, and she’s improved dramatically since then. Since we started with her, she’s actually regained a little bit of height and became a bit taller because her posture is much straighter now.”

Carrie is also out of pain, feeling better than she has in years. She says that visiting Jax Spine & Pain Centers and agreeing to the kyphoplasty treatments was one of the best things she’s done for herself.

“I see myself like an antique car,” she says. “I’m 67 years old, and at my age your body parts just start to break down a little bit, so you sometimes need to repair those parts. That’s what I did with my back, and I’m really glad I did.

“The procedure was nothing at all. It was very short, and everyone at Jax Spine & Pain Centers is very organized. You go in there, you lay down on the table, they start giving you the sedation and the next thing you know you’re done.

“I wasn’t even aware the procedure was going on when they did it, that’s how well it was done. And I couldn’t be happier with Dr. Akbary. He’s terrific, and thanks to him I’m walking a lot straighter than I was and walking unimpeded. I’m very thankful for that.”

Sign of the Times

It wasn’t long after Mary Lou Beyreis moved to Interlachen a few years ago that a sign she passes on her way to the grocery store began calling out. Being the animal lover that she is, it was inevitable that Mary Lou would eventually answer.

“The sign is for SAFE, which is an acronym for Saving Animals from Euthanasia,” says Mary Lou, 72. “It’s an animal shelter in Palatka, and since I love animals I thought there might be something I could do there to help out. Now, I volunteer there twice a week. I mostly clean the kitty cat room, which is fine because I have two older male cats myself. I also have two beautiful German shepherds, and I’m fostering two kittens that I’ve had since they were a day and a half old.”

A retired information systems manager, Mary Lou is an active sort who seldom spends time on the couch watching TV. That recently became her plight, however, after she experienced a disabling back injury.

To the best of her knowledge, Mary Lou was injured this past March while walking her dogs near her home. When two stray dogs began to follow, Mary Lou’s dogs shifted into protection mode.
“I could hear the growls from the other dogs getting closer as they came up behind us,” Mary Lou says. “Then, all of a sudden, my two dogs just stopped and stood in front of me. When I turned around, my one dog jumped up and body slammed me to the ground.

“After that, both of my dogs just stood over me as if to protect me, and the other dogs went away. I really appreciate my dogs being so protective, but I knew that being knocked down by a 125-pound German shepherd would probably cause some damage, and it did.”

Based on the pain she felt at impact, Mary Lou thought initially that the damage was a broken hip. She was able to get to her feet and finish her walk, but the pain in her back soon began to intensify. Then it became debilitating.

“I could still walk, but my back hurt so much that I had to walk all bent over like an old lady, which irritated me,” Mary Lou says. “Pretty soon, sleeping became a problem, too, because I couldn’t get comfortable lying on my back or side.

“It was hard working at the animal shelter, too, because I was in excruciating pain all the time. I couldn’t do a lot of the things I like to do, including gardening and other things outside, so I knew I had to get some help.”

The Sooner the Better

Mary Lou knew exactly where to go. Since 2014, she has been a patient at Jax Pain & Spine Centers, where she has been receiving annual steroid injections to alleviate back pain resulting from damage done during a boating accident.

When the pain from her recent fall persisted, Mary Lou returned to Jax Pain & Spine Centers and thought she’d wind up getting another steroid injection. After ordering and examining a new MRI, however, Dr. Hanes suggested a different treatment.

“The MRI showed that Mary Lou had somehow suffered a spinal compression fracture in her lumbar spine,” Dr. Hanes reports. “Once we had discovered that, we started talking about the kyphoplasty procedure. I explained to her that it’s a quick procedure done under sedation in our office and that patients receiving this treatment typically go home the same day feeling 100 percent relief from their pain.”

When recommending kyphoplasty, the doctors at Jax Spine & Pain Centers usually encourage their patients, especially older patients, to have the procedure done as soon as possible. Waiting can result in further damage.

“Dr. Hanes an excellent doctor whom I trust completely, and I recommend him to anyone, because he’s a miracle worker.” – Mary Lou

“There is a school of thought that says you can treat this kind of injury conservatively by putting a back brace on it and just waiting,” Dr. Akbary says. “And that may work for someone who is 22 years old, but in most cases you want to be proactive.

“The reason I say that is because I’ve seen patients who have a 30 percent fracture and for whatever reason they wait two weeks to do this. Then, by the time they come back and we get them on the table, their fracture is 70 percent.

“That’s because they continue to fracture. So we always want to be as proactive as we can, because the longer you wait the harder it is to restore any height that may have been lost. But if we catch it in time, this procedure can correct that problem.”

Dr. Hanes further notes that delaying treatment of a spinal compression fracture can lead to other health issues. Because of the associated pain, a compression fracture can inhibit breathing in some patients and spark spikes in heart rate and blood pressure.

“Miracle Worker”

Mary Lou weighed all those issues in her decision to have kyphoplasty. She is now among those who have greatly benefitted from the treatment, which has allowed her to resume an active lifestyle.

“The procedure was absolutely painless, the relief was immediate and now I’m walking, gardening and doing all the things I like to do outside again,” she enthuses. “I can even do housework and laundry again because the pain I was experiencing is all gone.

“For me, this treatment has been a life-changer. That’s why I only have wonderful things to say about Dr. Hanes and his staff. They’re all caring and professional.
Dr. Hanes really listens to his patients, and I love that he is so meticulous.

“I don’t know that another doctor would have ordered another MRI, but he did, and I’m so glad he recommended this treatment for me. Like I said,
Dr. Hanes is an excellent doctor whom I trust completely, and I recommend him to anyone, because he’s a miracle worker.”

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    • Jax Spine & Pain Centers

      Jax Spine & Pain Centers is one of north Florida’s leading providers in progressive interventional pain relief for the treatment of back, neck, shoulder, knee, hip and chronic pain. Their team of board-certified physicians and ... Read More

    • Hares Akbary, MD

      Hares Akbary, MD, is board-certified in anesthesiology and interventional pain medicine. He earned a Bachelor of Arts degree in molecular biology and biochemistry from Wesleyan University in Middletown, CT, in 2000 and his Doctor of Medic... Read More

    • Michael Hanes, MD

      Michael Hanes, MD, is a board-certified anesthesiologist and interventional pain medicine specialist. He earned his bachelor’s degree from the University of Michigan in 2006 and his medical degree from Michigan State University in 2010. He comp... Read More