Friday, April 3, 2009
Pain After Vertebral Augmentation
Vertebroplasty is effective at relieving pain for vertebral compression fractures. However there are some situations and which patients will continue to have pain afterwards. Which is commonly in 3 sets of patients.
The most common cause of residual back pain after vertebroplasty or kyphoplasty is incisional pain. This is usually mild and self-limited. With any procedure, even minimally invasive procedures, patients should expect some pain after the procedure due to the incision. However with vertebroplasty and kyphoplasty most patients don't even notice or report incisional pain. Patients who are the most at risk for having postoperative incisional pain include those on chronic narcotic medications such as Lortab, Percocet, Fentanyl or methadone. Even with these patients, however it is unusual for incisional pain the last more than one week.
A second cause of residual pain after the procedure is untreated fractures. Unfortunately, Medicare and most insurance companies will only let us fixed 1 or 2 fractures at a time, even in patients that have multiple fractures. Although this goes against common sense, unfortunately it is status quo. If we are unable to treat all of your fractures the first time, you can return for treatment at a later time--typically a few weeks.
A third common cause of pain after these procedures is pain that is unrelated to fractures. This would include pain due to chronic arthritis, disc bulges and other nonfracture spinal disorders. This also includes pain due to causes outside of the spine.
For example, hip pain commonly presents as back pain. Likewise, disease in the chest, such as pneumonia, can present as back pain. Although this can be problematic, these types of pain are typically not as severe as fracture pain.
It's important to speak with her physician if you experience any residual pain after the procedure. That way you and your physician can work together to find a solution to your problem and properly manage your pain.