Hi all,
In another thread Multibilly mentioned this:
"You might want to discuss a procedure known as kyphoplasty with the doctor. This is often used to treat multiple myeloma patients who have fractured their vertebrae."
Two weeks ago, I saw my neurosurgeon because I had a fractured T8 per xray, which he viewed and then ordered a cat scan, which found a second fracture in T11. This surgeon did excellent surgery on me previously, and he asked me "why are you here"?
I told him, "I thought I might be a kyphoplasty patient", he ignored this and when I pushed, "well when do I know the proper time to see you", he said, "the pain would be bad enough, and this would bring me to him".
My questions are: When are fractures left alone, and when is a kyphoplasty done?
Kate
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Re: Kyphoplasty - when is it recommended?
My two cents from somebody that has never had KP.
In scanning the papers on the topic, it seems like pain mitigation is typically the reason a doctor performs KP (which is essentially what your doc seems to be saying). But it also seems like one may have a better chance of maintaining vertebral height and better results if you do KP sooner (within two months of the fracture) rather than later.
Given it is your spine that is at stake here, I'd be looking for a 2nd opinion just to see if another doc is in agreement with your current doc. I'd also be asking the doc whether it is inevitable that the fracture will progress and lead to other complications and other fractures. If he/she says "yes", I would then be asking "why not do the procedure now?"
Also see:
http://www.medtronic.com/patients/spinal-fractures/device/questions-answers/
and
http://www.spine-health.com/treatment/back-surgery/description-kyphoplasty-surgery
Candidates for Kyphoplasty
Kyphoplasty cannot correct an established deformity of the spine, and certain patients with osteoporosis are not candidates for this treatment. Patients experiencing painful symptoms or spinal deformities from recent osteoporotic compression fractures are likely candidates for kyphoplasty. The procedure should be completed within 8 weeks of when the fracture occurs for the highest probability of restoring height.
In scanning the papers on the topic, it seems like pain mitigation is typically the reason a doctor performs KP (which is essentially what your doc seems to be saying). But it also seems like one may have a better chance of maintaining vertebral height and better results if you do KP sooner (within two months of the fracture) rather than later.
Given it is your spine that is at stake here, I'd be looking for a 2nd opinion just to see if another doc is in agreement with your current doc. I'd also be asking the doc whether it is inevitable that the fracture will progress and lead to other complications and other fractures. If he/she says "yes", I would then be asking "why not do the procedure now?"
Also see:
http://www.medtronic.com/patients/spinal-fractures/device/questions-answers/
and
http://www.spine-health.com/treatment/back-surgery/description-kyphoplasty-surgery
Candidates for Kyphoplasty
Kyphoplasty cannot correct an established deformity of the spine, and certain patients with osteoporosis are not candidates for this treatment. Patients experiencing painful symptoms or spinal deformities from recent osteoporotic compression fractures are likely candidates for kyphoplasty. The procedure should be completed within 8 weeks of when the fracture occurs for the highest probability of restoring height.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Kyphoplasty - when is it recommended?
I sustained 5 compression fractures en route to the discovery that I had multiple myeloma. It was my chiropractor who actually got me steered in the right direction upon discovering the fractures with an X-ray. The pain was very intense. I was driving tractor trailers at the time and had to take a week off.
Kyphoplasty was suggested to me early on and I met with Sloan Kettering's back surgery specialist. He acknowledged my pain, but commented that I was surprisingly mobile and advised we wait.
We met again 3 months later. I suggested the procedure might contribute to a better quality of life while helping to correct my posture and restore some of the 4-1/2" I had lost. He explained that they only treat 2-3 vertebrae at a time, that he usually reserves the procedure for patients in more pain, or who were much less mobile than me. He suggested that physical therapy and exercise would go a long way toward improving my posture and by strengthening my core I would also be strengthening my back.
Through chemo I suffered 6 more compression fractures but they were mild compared to the first ones. I met the surgeon one last time and we decided to forego the procedure. Frankly, back surgery scares me ... eye surgery too. I'm 5'10", not 6'2-1/2".
But I think I'm glad I didn't have the kyphoplasty.
Kyphoplasty was suggested to me early on and I met with Sloan Kettering's back surgery specialist. He acknowledged my pain, but commented that I was surprisingly mobile and advised we wait.
We met again 3 months later. I suggested the procedure might contribute to a better quality of life while helping to correct my posture and restore some of the 4-1/2" I had lost. He explained that they only treat 2-3 vertebrae at a time, that he usually reserves the procedure for patients in more pain, or who were much less mobile than me. He suggested that physical therapy and exercise would go a long way toward improving my posture and by strengthening my core I would also be strengthening my back.
Through chemo I suffered 6 more compression fractures but they were mild compared to the first ones. I met the surgeon one last time and we decided to forego the procedure. Frankly, back surgery scares me ... eye surgery too. I'm 5'10", not 6'2-1/2".
But I think I'm glad I didn't have the kyphoplasty.
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1World - When were you/they diagnosed?: 1/4/2012
- Age at diagnosis: 59
Re: Kyphoplasty - when is it recommended?
My dad had lost inches in height. His family doctor was against kyphoplasty. The oncologist and specialist never mentioned it. When he saw a radiologist familiar with myeloma, he was told he was in danger of an imminent vertebra collapse and paralysis. He was extremely careful not to lift anything more than 10 pounds, careful with all movements and feared a fall would leave him paralyzed.
He had kyphoplasty on the worst vertebra, with no problems, while undergoing chemo. This was done after completing radiation, which had relieved all the pain.
I've read about others who have had a collapsed vertebra, become paralyzed, then had surgery, and were lucky to regain control of legs, bladder, bowels. My dad did not regain height, but that was the least of his worries!
He had kyphoplasty on the worst vertebra, with no problems, while undergoing chemo. This was done after completing radiation, which had relieved all the pain.
I've read about others who have had a collapsed vertebra, become paralyzed, then had surgery, and were lucky to regain control of legs, bladder, bowels. My dad did not regain height, but that was the least of his worries!
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MMdaughter - Name: MMdaughter
- Who do you know with myeloma?: dad
- When were you/they diagnosed?: Jan 2013
- Age at diagnosis: 67
Re: Kyphoplasty - when is it recommended?
Thank you Multibilly, 1world and MMdaughter for your replies.
I had done extensive research before I even decided to see the neurosurgeon. However, personal surgery experience, or info from others, is still very helpful in situations like this. I have the weird feeling that one if not two (T8/T11) of my fractures was caused by the intensive coughing I had going on for about 2 months in November and December of 2013.
Well, let's wait and see. So far I'm not in any serious pain.
Again, thanks,
Kate
I had done extensive research before I even decided to see the neurosurgeon. However, personal surgery experience, or info from others, is still very helpful in situations like this. I have the weird feeling that one if not two (T8/T11) of my fractures was caused by the intensive coughing I had going on for about 2 months in November and December of 2013.
Well, let's wait and see. So far I'm not in any serious pain.
Again, thanks,
Kate
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Kate - Name: Kate
- Who do you know with myeloma?: myself
- When were you/they diagnosed?: Dec. 2012
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