Triple Threat

Three valuable advantages of kyphoplasty

Five months ago, Anna Nico caught a miserable cold. With it she developed a deep, intense cough. She realized it was a complication of the cold with her existing breathing problems. What she didn’t understand was why her back hurt so badly every time she coughed.

Photo by Jordan Pysz.

After kyphoplasty, Anna can be on her feet without pain.

“I couldn’t pinpoint the pain, but it was awful. It felt like my whole back was on fire,” she describes. “Each time I coughed, I got this pounding pain in my back. It was like I was suffocating.
“The pain was excruciating, and I couldn’t get out of bed. One time, it took my husband and son thirty-five minutes to get me up. After that, I slept in a chair for four months.
“I went to my lung doctor, who gave me something for my cough. When I explained about my back pain, he told me I needed to get it checked out; it didn’t sound like it was related to the cough. He gave me a prescription, and I went and got an x-ray.”
The x-ray showed Anna’s problem clearly. She had two compression fractures in her thoracic vertebrae. A compression fracture is a break in a spinal vertebra, which collapses onto the one below it. As a result, spinal nerves get pinched, causing pain and weakness.
Right away, Anna sought help from the doctor who’d been treating her sciatica pain, Gerald E. Trimble, MD, who is a board-certified pain management practitioner. His practice is Minimally Invasive Spine Care, which has offices in St. Petersburg and Clearwater.

Identifying the Source

After consulting Dr. Trimble about her back pain, he confirmed Anna suffered from vertebral compression fractures.
Dr. Trimble typically treats the fracture with conservative measures, such as a back brace or management through medication.
“Vertebral fractures can sometimes be treated conservatively,” confirms Dr. Trimble, “because some will eventually heal on their own. With a patient whose symptoms are mild, or who is essentially asymptomatic, we prescribe a back brace to postpone or eliminate the need for additional treatment.
“If the fracture compresses further – or if the patient does not improve – we don’t hesitate to recommend taking more aggressive action to alleviate the pain.”
To some degree, acute pain can be beneficial, observes Dr. Trimble. It serves as a warning signal that a medical condition needs to be addressed. “Chronic pain, however, serves no purpose except to make you uncomfortable – even miserable,” he elaborates.
“At our practice, we view chronic pain as a disease process, not merely a symptom to be tolerated as part of an underlying condition. Our first objective is always to determine where the pain originates and then apply specific techniques to treat it.
“Once the source of pain – the pain generator – has been identified, the underlying pain mechanism is addressed and the treatment scheduled. In each case, we approach pain relief with the least invasive methods available, with the goal of postponing – or even eliminating – the need for invasive surgery.”
“Dr. Trimble checked my x-ray and ordered other tests, including blood work. He’s very thorough,” notes Anna. “He’s also very compassionate and understanding, and he knows what he’s doing. He decided to do an injection procedure on me.”
The procedure he chose stabilizes the fracture and eases pain. It’s called kyphoplasty.

Refined Technique

Dr. Trimble reports that newer technology enables surgeons to provide a fast, effective solution to vertebral compression fractures.
“We now offer kyphoplasty, which is proving to be valuable in three key areas – providing significant pain relief, stabilizing the fracture and re-establishing much of the lost vertebral body height.”
Kyphoplasty is actually a refinement of a procedure called vertebroplasty, and offers additional advantages. During kyphoplasty, a balloon is inserted into the fractured vertebra that elevates the compressed bone. This helps return the spine to a more natural position. The newly created space allows for the injection of fast-drying bone cement, which helps achieve the correction in the deformity of the vertebra.

“Before the kyphoplasty, my pain ranked about a nine out of ten. Afterward, it was zero.”– Anna

“As we inflate the balloon, we can often reproduce much of the height in the bone,” informs Dr. Trimble. “The other advantage to the balloon is that it pushes the healthy bone to the periphery, leaving a cavity that can then be filled with bone cement.”
“During the procedure, Dr. Trimble told me exactly what he was doing,” states Anna. “He said, Now you’re going to feel a little pinch. Don’t worry about it. It’s going to be okay. I felt a little pinch when the needle went in, and that was it. The procedure wasn’t painful.”
The doctor adds that kyphoplasty is an improvement over its predecessor, vertebroplasty.
“Vertebroplasty is an injection of cement without inflating a balloon into the area first,” he explains. “It doesn’t attempt to correct the deformity. Secondly, vertebroplasty requires us to put slightly more pressure on the cement in order to get it between the cracks of the fracture. Consequently, I prefer kyphoplasty to vertebroplasty.
“With kyphoplasty, the bone cement hardens quickly, stabilizing the fracture, and the stability from the cement offers significant pain relief for the patient – usually within hours of the procedure or even sooner.”

Up and Running

Kyphoplasty was an excellent option for Anna. Now when she coughs, she doesn’t feel the fiery pain in her back. Like many patients, she felt relief quickly and was soon able to be active again.
“After the procedure, I went home and I was walking,” she enthuses. “The nurses told me to put ice on my back, so I did, and it was fine. I was up and running the next day. Before the kyphoplasty, my pain ranked about a nine out of ten. Afterward, it was zero.”
Today, Anna sleeps in a bed. She suffers minor discomfort in her back, but it’s likely related to the osteoporosis she battles. Osteoporosis puts her at risk for additional compression fractures. If that happens, she knows the right treatment and where to get it.
“I really like Minimally Invasive Spine Care and Dr. Trimble,” she says. “I’d recommend him to anyone!”

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    • Minimally Invasive Spine Care

      For many people, pain is a constant presence. It can make daily tasks difficult, or it can be entirely debilitating. Minimally Invasive Spine Care specialists, working together with you, can help relieve or decrease your pain and assist your ... Read More

    • Gerald E. Trimble, MD

      Gerald E. Trimble, MD, is board certified by the American Board of Anesthesiology, specializing in pain management. He received his medical degree from the University of South Florida College of Medicine and served a transitional internship at ... Read More

    • Michael L. Whitworth, MD

      Michael L. Whitworth, MD, is board certified by the American Board of Anesthesiology, the American Board of Pain Management and the American Board of Pain Medicine. He is also a fellow of the American Board of Minimally Invasive Spine Med... Read More