Widening indications for spinal surgery in the osteoporotic population
Professor Richard Hall - University of Leeds
Awarded £87,284 in 2007
Patients with osteoporotic or osteopenic bone are often excluded from receiving many commonplace and generally successful spinal operations that have been shown to provide significant improvements in the quaility of life of the population more generally. In particular, those procedures that that require the insertion of an implant into the disc space, such as a fusion device or disc replacement, are often precluded in the elderly population (> 50 years of age) for fear of the device sinking into the adjacent vertebrae. Recently, a key-hole surgery technique called vertebroplasty has demonstrated considerable promise in treating fractures in the osteoporotic spine with considerable pain relief occuring within 1-2 days of the procedures. The complications associated to this technique are low. One innovative use of vertebroplasty may be in the prophylactic strengthening of the vertebrae, before fracture has occurred, so that disc or fusion implants can be used to treat other significant ailments, such as low pack pain due to degenerative disc disease or herniateed disk, without the fear of subsidence and subsequent revision. However, before this is advocated clinically careful biomechanical assessment needs to be undertaken within the laboratory to optimise the vertebroplasty procedure to ensure the best possible clinical outcomes.