Back At It

Procedure brings immediate relief from spinal compression fracture.

By the time Christopher Columbus reached the Americas, natives along the southern continent’s west coast were already mixing rice with the flavorful meat of the Muscovy duck to create a dish that later came to be known as arroz con pato.

Centuries later, Mary Oshiro still thinks that dish is the best thing to come out of its land of origin, Peru.

Kyphoplasty alleviated Mary’s back pain and allowed her to resume her active lifestyle.

Kyphoplasty alleviated Mary’s back pain and allowed her to resume her active lifestyle.

“All the food there is great,” Mary says of Peru, the country she grew up and lived in until she relocated to the United States 22 years ago. “But the best is rice with duck, or what some people call duck rice.”

Mary, 73, hasn’t had a good serving of duck rice in years. She loves to eat but hates to cook, and the closest Peruvian restaurant she knows of is in Orlando, a city she seldom visits, in part because she’s just too busy.

“I still work, and work keeps me very busy,” Mary explains. “I’ve worked in customer service for T.J. Maxx for years, and when I’m not working, I like to volunteer. I also like to exercise a lot. Every day I do 100 pushups.”

In February, Mary suffered a bad fall that left her with so much back pain that she couldn’t do one pushup. Her pain was so great that it also forced her to cut back on her work hours.

“I fell on my back while getting out of my car,” Mary explains. “At first, I couldn’t get up because I was in so much pain. But my husband helped me up and right away he took me to urgent care.”

Doctors at the urgent care facility found nothing seriously wrong with Mary, whose pain subsided over the next couple of days. After resuming her normal daily activities, including pushups, the pain returned with a vengeance.

“It was a very sharp pain in my lower back,” Mary reports. “It hurt no matter what I did but was especially bad if I tried to move to the right or left. I couldn’t stand for very long either. That’s why I had to cut back my hours at work.”

Mary tried for a few months to work through the pain, treating it primarily with over-the-counter medications. When the medications failed to provide relief, she visited her primary care physician, who ordered an MRI.

After reviewing the MRI, her primary care physician recommended that Mary visit a specialist. Explaining that her pain was likely caused by a spinal compression fracture, he suggested she visit Nicholas Giordano, MD, at Central Florida Spine & Pain.

Painless Procedure 

As its name suggests, a spinal compression fracture is caused by a compression of a bone in the spine. As with Mary, it can be triggered by a fall or even something as innocuous as a sneeze. Osteoporosis, which results in loss of bone mass, is another leading cause.

If left untreated, a spinal compression fracture can result in sufferers walking hunched over. That’s why Mary’s primary care physician immediately sent her to Dr. Giordano, who reviewed her MRI, confirmed the diagnosis and recommended a remedy called kyphoplasty.

Kyphoplasty (pronounced kifo-plas-tee) is a minimally invasive injection-like procedure that can be completed in about 30 minutes under light sedation in the offices of Central Florida Spine & Pain.

The procedure is performed through a small incision in the back. 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 then filled with a fast-drying cement that immediately stabilizes the fracture, alleviating pressure on the nerves and eliminating the pain. 

“There are two methods to treat a spinal compression fracture,” Dr. Giordano educates. “You can be very conservative and simply brace the patient and let the fracture heal on its own, or you can do a kyphoplasty.

“With the first method, patients are immobilized for three to four months. When they heal, the swelling in the bone goes away, but you still have the fracture and the loss of height that comes with it. Also, there’s no guarantee the bone won’t fracture more in the future when you start moving again. That’s why I lean more toward kyphoplasty, which allows me to do a couple of things that are very beneficial to the patient.

“First, during the procedure, I can also take a biopsy that will gauge the integrity of the bone and show if there is anything pathological, like a type of cancer, that may have caused the fracture. But more importantly, this procedure restores the height of the bone. And when you put the cement in, it hardens and prevents the bone from fracturing further because once you suffer this kind of fracture, you’re typically prone to more of the same.”

When performing a kyphoplasty procedure, Dr. Giordano uses a kit developed by Stryker Corporation, a medical technology company, called the Stryker AVAflex system. The Stryker kit is designed to simplify the procedure while reducing patient trauma.

“The cement you get with the Stryker kit is far superior to anything else because the consistency is always the same,” Dr. Giordano explains. “That allows me more control over what I’m doing and leads to a decrease in procedure time and patient discomfort.”

No More Pain

Dr. Giordano first saw Mary in June, four months after her fall. His recommendation was based on the fact that her fracture had not healed and remained swollen. She accepted and had the kyphoplasty done within a week of meeting Dr. Giordano.

“Kyphoplasty is one of my favorite procedures because it provides instant relief and allows people to be active again right away,” Dr. Giordano educates. “If you have to spend three or four months in bed, your muscles atrophy and you lose strength at an incredible rate.

“That’s especially the case with someone like Mary, who is in her 70s but is very active. Kyphoplasty was perfect for her, and her response was immediate. Following the procedure, she got up off the table pain-free and was soon challenging me to a pushup contest.”

Dr. Giordano isn’t kidding. During a follow-up visit, Mary did challenge the doctor to a pushup contest, further proof that the kyphoplasty worked as intended.

“When I first went to see Dr. Giordano, he told me, I’m going to make sure you don’t have any more pain, and he was true to his word,” Mary enthuses. “I walked out of his office the day of the procedure with no pain, and I haven’t had any pain since. And now I’m back doing my exercises every day and working, and I couldn’t be happier.

“From the moment I met Dr. Giordano, I felt like he really cared about me and was so concerned about my pain that I thought, This is going to be my doctor. I told him from the beginning that I wanted my quality of life back, and he did that for me. I wholeheartedly recommend him to anyone. He’s a doctor you can trust.”

© FHCN article by Roy Cummings. Main photo by Jordan Pysz. Inset photo courtesy of Central Florida Spine & Pain. mkb
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    • Central Florida Spine & Pain

      If you’re in pain, Central Florida Spine & Pain can help. The highly skilled, friendly, and compassionate team at Central Florida Spine & Pain can effectively address your pain, so you can get back to enjoying your life to the ful... Read More

    • Nicholas Giordano, MD

      Nicholas Giordano, MD, is a board-certified interventional pain management specialist. He earned his bachelor’s degree in biological science from the State University of New York at Binghamton in 2006 and his medical degree from St. Georg... Read More