How do you spell relief?
For many, particularly older women suffering from painful spinal fractures caused by osteoporosis, it is spelled vertebroplasty.
That is the relatively new innovative procedure being performed at Inova Mount Vernon Hospital. It is bringing almost instantaneous relief to those who otherwise would be forced to rely on medication or surgery to reduce their severe back pain.
"I never suffered from health problems. I was always a sports person. Then I had two breaks in my back, one after the other. I was immobilized and in excruciating pain." That was how Susanne Lesser, 78, described her out-of-the-blue encounter with the fractured vertebra caused by osteoporosis.
Her knight in medical innovation armor was Calvin Neithamer, MD. He is an interventional radiologist, and one of the leading practitioners of vertebroplasty in the nation. "Performing vertebroplasty is truly gratifying because relief is virtually instantaneous," he said.
"It is a relatively new procedure in the United States. But it was first done in France in 1984. It has been building here, particularly over the last four years. I've been doing it about two years," Neithamer noted.
The procedure is performed by inserting a thin needle into the fractured vertebra and then injecting surgical glue into the bone to fill the holes caused by osteoporosis, according to Inova spokesperson Kathleen Thomas.
"We numb the skin, make a small nick, and administer the cement," Neithamer explained. Lesser underwent her first treatment in October.
When a second break occurred in January, in another vertebra, she returned to Inova Mount Vernon. Dr. Neithamer performed his "magic" once again. "When they asked me to rate the pain of the second break on a scale of one to ten, I said eleven," Lesser said. She is now pain free again.
"After I met the surgeon I had absolute faith he knew what he was doing," Lesser insisted. "I had so much pain before the treatment it was unbearable. But afterward, in both cases, I had immediate relief."
NO STRANGER TO HARDSHIP
Lesser, who lives on Cool Spring Drive in the Mount Vernon area, is not one to just accept a broad based diagnosis or write off pain and discomfort as a side affect of aging. A native of Austria, she survived World War II and its deprivations.
As the owner of a sports store in Salzburg, one of her customers was a foreign service officer with the State Department and his wife. Within a two year period her husband and the foreign service officer's wife both died.
At the time she had a nine-year-old daughter and he had a Porsche.
After they married they had a son and he got rid of the Porsche.
They first came to New Jersey and then he took an assignment in Japan. "We figured with the difference in the expenses and pay we could save enough in two years to have a down payment on a house," she said.
"I told him we could live on half the salary and save the rest. I didn't go around buying all that Japanese souvenir stuff as so many do. He didn't think we could save that much in two years but we did. I am German and I am frugal," Lesser emphasized.
Following the tour of duty in Japan they returned to the states, bought the house, and she became a professional social worker specializing in serving the needs of the elderly. "I was well aware of the affects of osteoporosis from my work," she said.
"But I had no warning on the first fracture. It just happened. I first went to my regular doctor because I had this back pain. I was treated in the traditional ways, with heat and pain killers.
"When nothing helped they sent me to the hospital for x-rays and an MRI. That's when they spotted the break," she recalled.
AN INTERNAL SPLINT
Vertebroplasty is an outpatient procedure performed in about an hour, according to Dr. Neithamer. "It does not help the disc at all. It is designed for patients who have vertible fractures.
"It has to be the right patient with the right problems," he clarified. "I conduct a thorough interview with the patient before I undertake the procedure.
"The best way to explain the procedure is to compare it to an internal splint. If you break your arm they put a cast on it to keep it immobile. With the spine there is no real way to put it to rest except total immobility in bed. That's not really acceptable," Neithamer said.
"This procedure provide stabilization to the vertible body. The results have been amazing and the relief is instantaneous. There is also no limit to the times it can be done and no age limit for the patients," he noted.
Lesser shared his enthusiasm. "I can drive. I walk around the block everyday. I can do almost everything I did before — just slower. I go food shopping — just get them to put the order in more bags so they are lighter. And I can sit on regular furniture. I hope that in two or three months I am good as new," she said.
"It's a great procedure and everyone at the hospital was so very informative. And I wanted to know a lot," she admitted. "When I asked if it could happen again, the doctor was very honest and said he couldn't see into the future. But if it did happen again, he was also able to fix it again."
Lesser expressed only one complaint. "The operating room looked like a space ship. It's amazing how they can deal with all those instruments. I wanted to watch but I couldn't. I was on my stomach."
There have been some adjustments to the lifestyle of this two time widow. Her daughter, now living in Chappaqua, NY, rearranged the kitchen so that all the necessary items are at standing level. All the throw rugs from her bi-level home have been removed to avoid slipping. And she uses a hand operated grasper to pick up fallen objects.
BEING PAIN FREE IS POSSIBLE
When asked why vertebroplasty is performed by radiologists Neithamer explained, "Radiologists are very skilled as to where to place the needle most comfortably." It was also a radiologist who first performed the procedure, he noted.
Statistics show that every year osteoporosis causes more than 700,000 vertebral or spinal fractures. Verteoplasty will not prevent fractures from occurring. That is why a diet high in calcium and vitamin D, in addition to exercise, are recommended by medical advisors.
"Women should be aware that they are more at risk for thinning of the bones than men. But all patients should be aware bones become brittle with age. The goal is to not have these breaks occur," Neithamer pointed out.
"But they should also know there is a treatment for severe back pain other than just heavy medication. Verteoplasty is picking up momentum. It's becoming a real topic for interventional radiology. I now get calls from all over the country," he said.
Studies suggest that 75 to 90 percent of patients treated with verteoplasty have complete or significant reduction of their pain. And not in days or even hours, but instantaneously.
"Without vertebroplasty, I would be on painkillers and have a low quality of life. Now I require no medication. I just take some Advil every now and then. But that is for my arthritis not for the osteoporosis," Lesser said with a smile of gratitude.