Thursday, February 26, 2009
We get a lot of different questions from our patients about bone cement that is used to fix painful VCFs. While an exhaustive explanation is beyond the scope of this blog, I am going to answer some of the most common questions we get.
What is bone cement?
Also known as bone glue, the material we commonly call 'bone cement' is a polymer called polymethylmethacrylate, or PMMA for short. This is made from mixing a powder and a liquid together in the operating room. This forms a paste that quickly hardens up in about 15-25 minutes. It starts out thin like cream, then gets thicker, like toothpaste by the time it's used in the body. Then it gets as thick as modelling clay toward the end of the procedure. By the time the procedure is over, the PMMA is hardened to a consistency just harder than bone.
Can I melt the cement if I use a heating pad?
No, once the bone cement sets up it's that way forever.
Can I break the cement by certain activities?
No, I've never heard of anyone breaking their cement. Rarely, a patient may have another fracture at a treated level, but it's usually in severe osteoporosis and not usually related to a known cause.
Does the cement dissolve over time?
No, there is no evidence that the cement dissolves or dissipates over time.
Can the cement leak into the body?Once it sets up (by the end of the procedure) the answer is no. During the liquid state, it can leak lots of places. This is usually only an issue if a large amount leaks into the veins or by the spinal cord or nerves. Careful observation during injection is required to avoid this.
I've heard bone cement heats up; can it burn you?
When the PMMA hardens, it gives off heat. This is a common chemical phenomenon known as an exothermic reaction. If there is cement in contact with nerves, for example, it can cause irritation, however, this is very rare. Actually, the heating process has been theorized as one cause of pain relief.
That's it for now. As we get more questions we'll post them here, as well as on our FAQ at www.tulsamsk.com
Tuesday, February 24, 2009
In the last post, we talked about differences in training that different doctors receive. Many doctors go to a weekend course to learn the procedure--and they may have never actually treated a live patient before they operate on you or a loved one. So, it's important to check their credentials out.
In this post, we'll talk about how ongoing experience affects performance with doctors. We'll also include a list of questions that you may find useful to ask your physician.
Saturday, February 21, 2009
In my next post, we'll talk about other factors in selecting a doctor for fixing fractures, including ongoing experience. I'll also include a list of questions to ask your doctor to help see if they are the right doctor for you.
Wednesday, February 18, 2009
If her doctor thinks her pain is due to the fractures, then yes, she is a candidate for fixation. We routinely perform vertebroplasty, kyphoplasty and even spinoplasty in patients over 100. This can be done even if the patient has severe medical disease, such as heart disease, stroke or diabetes. This is a significant advantage of these procedures because they do not require general anesthesia like major surgery does.
My mother got a compression fraction of a lumbar vertebrae last July. She has constant pain but was told there is no treatment. She is 92. She also has 2 old vertebral compression fractures. Would she be a candidate for spinoplasty?
The interesting part of the question is spinoplasty. In experienced hands, spinoplasty is effective, however, it is not currently performed by many doctors. Personally, I performed the first spinoplasty in Tulsa. However, I have lately done more cement procedures because they cost the patient less and are essentially 100% effective at taking away pain.
read more digg story
We are in the process of forming an Osteoporosis Support Group in cooperation with the National Osteoporosis Foundation so check back as we will be posting details here in the next few weeks.
Friday, February 13, 2009
If you're planning on attending the Tulsa Women's Expo (see previous post) on Saturday, make sure you're there at 11am. Dr. Webb will be speaking about Osteoporosis on the Lifestyle Stage.
The Lifestyle Stage is located immediately to the right from the main entrance to the QuickTrip Center. Admission is $5 at the door with hundreds of vendors. Hope to see you there!
Come on out to the Women's Expo at the Tulsa Fairgrounds. We are located at booth 219, near the main stage in the QuickTrip Center. This is the building that has the golden driller in front of it.
While you're there, chat with our staff and be sure to sign up for our free gift basket drawing. There is plenty of free information about osteoporosis at our booth, as well as numerous freebies!