[ilovemc]

Kyphoplasty for "old" fractures

by ilovemc on Thu Sep 18, 2014 9:17 pm

My husband was diagnosed January 2 this year, and is in complete remission on Revlimid.
He has 11 vertebral fractures. We've seen 3 different providers, all who say that the fractures are too "old" for kyphoplasty. We started the process of attempting kyphoplasty in February, so less than one month after diagnosis. I'm not sure why a 4 week old fracture is considered old.

How feasible is it to do a kyphoplasty "later down the road"? We'd really like to try this, and are willing and able to travel anywhere in the US for a provider willing to try.

My husband is dependent on Oxycontin (oxycodone) for pain control, which is becoming more difficult to get, as everyone thinks he should be doing "better" by now and there are such strict pain management laws in place these days.

I have 2 small kids, under 2, we need him to be functional in our lives.

[caregiverdee]

Re: Kyphoplasty for "old" fractures

by caregiverdee on Fri Sep 19, 2014 1:17 am

Hi ilovemc,

Sorry to hear about your situation.

My husband was told immediately at the time of diagnosis that his fractures had healed and he would not be a candidate for kyphoplasty. We saw a specialist in kyphoplasty a year later and he said the same thing and said he would not perform the procedure.

My husband continues 2 1/2 years later to have a lot of pain and has lost 6 inches in height. But he does fair with pain medication and exercises.

Sorry, this is not good news, but maybe someone else has had a different experience.

Dee

[Dr. Heather Landau]

Re: Kyphoplasty for "old" fractures

by Dr. Heather Landau on Fri Sep 19, 2014 2:11 am

Hi ilovemc,

Before I say anything, I should note that I am not a neuroradiologist, nor do I perform these procedures.

That being said, I have referred patients for kyphoplasty when pain persisted after initial therapy despite adequate disease control (i.e., no significant signs of myeloma in blood test results or obvious active bone destruction). In that setting, there still can be bone damage that can benefit from kyphoplasty, and I have seen patients improve after kyphoplasty for "old" fractures.

However, one must realize that there is a certain type of fracture that can be fixed by the procedure, and the spine MDs (neuroradiology at our center) are best at selecting patients. I would suggest that you find out from your husband's doctors more specifics about why they do not think the procedure will help, and that you also consider seeking another opinion. But also understand that if someone does agree to do the procedure, it is not guaranteed that it will work.

Best,
Heather Landau

[kullybunnny1]

Re: Kyphoplasty for "old" fractures

by kullybunnny1 on Fri Sep 19, 2014 7:11 am

I also had a total of 11 compression fractures, and even after a year filled with initial induction therapy and a transplant, I had the remaining 8 done. The first 2 were done prior to my diagnosis of multiple myeloma and the final 2 kyphoplasties were done last month.

I achieved both pain relief and the confidence of a stable spine!

As the doctor said, not all are candidates, but don't take no for an answer if a yes is possible.

All the best!
Kully

[ilovemc]

Re: Kyphoplasty for "old" fractures - advice / experiences?

by ilovemc on Sat Oct 11, 2014 8:52 pm

Thanks Dr Landau. We've found someone in Indy who is willing to do this, and who is sort of bewildered as to why our other providers didn't think it was a possibility. I'm crossing my fingers and toes that my hubs gets some pain relief.

I have to say, I'm a bit disappointed in our oncologist for not helping us seek this out, or even re-imaging his spine during treatment. We started with 1 compression fracture at T4 and now he has 11. (It's been less than a year). It's a sticky situation because he's a friend and colleague, but I think that even though MC (my husband) is in remission, we are going to seek out another oncologist for management.

Anyway, thanks for your advice. I do appreciate it.