A neurosurgeon at Comanche County Memorial Hospital is introducing two procedures to the hospital and the area to help patients dealing with back pain.
Dr. Christopher Neumann, a neurosurgeon, said people with compression fractures in their spine can benefit from a procedure called Kyphoplasty, a minimally invasive treatment to quickly relieve the pain. Around 700,000 Americans suffer spinal fractures every year, but most suffer without going to a doctor.
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How Kyphoplasty works
Dr. Neumann walks patients through how the procedure works.
“Here’s your broken bone. A needle gets put in. A balloon gets blown up into the bone. The balloon comes out and then cement gets put into this space and the needle is removed,” he said.
He says around 700,000 people report compression fractures each year, but only about 20,000 Kyphoplasties were done in 2017.
“So there’s a big gap between the two, and the reason is that some of these breaks — they’re not that painful and so some patients white knuckle it and say ‘I don’t need to go to the emergency room or see my doctor about this’ or it’s something else and they don’t realize that they broke their spine and it heals up and they’re ok,” Dr. Neumann said.
But Dr. Neumann said about a fifth of compression fractures are so painful they disrupt daily activities.
“The way to treat that, in the old days, is that you take narcotic pain meds and you lie in bed for weeks until you get better,” he said.
He said after that, patients would transition to a back brace for 12 weeks.
“In the last over 20 years, I’ve been treating with Kyphoplasty. Which is a procedure that can actually provide relief almost instantaneously. A lot of times, I hear in recovery ‘my back pain is gone’,” Dr. Neumann said.
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Causes and risks of compression fractures
He said the three most common causes of compression fractures are from trauma, like a fall, osteoporosis, or a tumor that’s invading the bone. Dr. Neumann said having a fracture decreases mobility.
“If you aren’t moving around as much, your chance of dying actually gets higher. So, you don’t move as much, you get a blood clot in your leg cause you’re not walking and that blood clot becomes a pulmonary embolism, so there is a documented risk for reduction in mobility,” he said.
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New Intracept procedure
Dr. Neumann is also starting to do another, newer procedure, called Intracept. It focuses on the nerve inside the bone in the spine causing pain.
“The procedure would be to access the bone in a very similar way, to put an electrode to basically cauterize inside that bone and disconnect the pain signal and it tends to be permanent,” he said.
He said in the past they’ve focused on the disc being the cause of the pain, but research has shown the bone could be where the pain is coming from.
“When the discs break down, they produce these inflammatory sites of kinds that are part of arthritis and that spreads over to the edge of the bone and then you start to see these inflammatory changes to the actual bone itself, and when we get an MRI, we can actually see these changes,” Dr. Neumann said.
Dr. Neumann said the changes used to be ignored and looked at as modic changes. But now, they believe it’s showing pain from the nerve inside of the bone.
“Accessing the bone is very straight forward – putting a needle through this bony channel, getting an electrode right at that nerve, cauterizing that nerve and that stops the pain signal and that makes the pain go away,” he said.
Dr. Neumann said if someone wants more information about either of these procedures, to get a referral from their primary doctor. Unless they go to the ER because of a compression fracture, then the ER will notify his office and he can see the patient.
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