Vertebroplasty

Part of my Multiple Myeloma is having compression fractures in my spine. When I was diagnosed, I had an MRI which showed I had the compression fractures in T12 and my lumbar spine. A compression fracture is what occurs when one or more bones in the spine weaken and crumple. They are typically caused by a loss of bone mass (osteoporosis) that occurs as a part of aging. A fall, cough or lifting of a heavy object may cause a fracture of the back bones. In my case, my MM caused the fractures. All of the junk protein that was in my bone marrow was pushing out so much that it caused the fractures in my spine. Some symptoms of compression fractures are back pain, lost height and a hunched-forward posture. All of which I have. I used to be 5'6" tall. Since my diagnosis I have shrunk to about 5'4". I've lost a whole 2 inches because of my fractures.

Since my diagnosis, and after I gave birth to Brandon, I have been treating the pain with medication. I started with Tylenol 3 (with codeine), then to Dilauded (Hydromorphone) and more recently, extended release morphine. I have changed so much in what I take in the last year because my body would get used to a prescription and it wouldn't work anymore. At this time, I am on the morphine ER twice a day with the use of Dilauded as breakthrough pain. Basically, when the pain is so bad that just the morphine ER doesn't do the job. But, come Monday, all of that is going to change. Monday I will be having a procedure done on/in my spine that will take away all pain.

It is called Vertebroplasty. I learned about this procedure the beginning of October at a support group for patients and caregivers of Multiple Myeloma. A fellow patient who is about my age had it done and she raved about it. Said the only pain she had was the day of the procedure. So, I asked Dr. W at Stanford about it and he said it was a good idea to do it and he would suggest it to Dr. H at Kaiser. Not just that, but my nurse for Dr. H suggested I should do it. So, I sent Dr. H an e-mail saying I was interested in it and he sent the referral over. This has all happened in the matter of two weeks by the time I have the procedure done.

What is Vertebroplasty, you ask? Vertebroplasty is an outpatient procedure for stabilizing compression fractures in the spine. Bone cement is injected into back bones (vertebrae) that have cracked or broken, often because of osteoporosis. The cement hardens, stabilizing the fractures and supporting your spine. The cement instantly hardens. It is considered a minimally invasive surgical procedure because the procedure is done through a small puncture in the patients skin (as opposed to an open incision).

Vertebroplasty is treated with local anesthesia and light sedation usually in an x-ray suite or operating room on an outpatient basis. The procedure usually takes about one hour to complete. A biopsy needle is guided into the fractured vertebra under x-ray guidance through a small puncture in the skin.  A specially formulated acrylic bone cement is injected under pressure directly into the fractured vertebra, filling the spaces within the bone - with the goal of creating a type of internal cast to stabilize the vertebral bone. The needle is removed and the cement hardens quickly, about 10 minutes, congealing the fragments of the fractured vertebra and stabilizing the bone. The skin puncture is then covered with a bandage. Shortly after the cement has hardened, I will be free to leave and go home.

I will be on bedrest for the first 24 hours. After that, I will be able to gradually increase activity. I may have some soreness for a few days from the puncture site but nothing a little ice pack can't fix. Typically, I should have about 90% or better reduction in pain in that first 24-48 hours with an increased ability to perform daily activities shortly thereafter. Recent study shows that a patient with compression fractures who undergoes a vertebroplasty procedure, can have relieved pain for up to at least three years afterwards.

For me, this procedure means being able to pick up and carry Brandon without any pain. It means being able to get on the ground and play with him. To chase him around with ease. Not only that, but I will be able to get back to my old workouts and not just walk for a workout. I will be able to cook more meals and help Eric with cleaning around the house a lot easier as I will not have the pain that comes from standing/walking for long periods of time. This procedure will basically give me my life back. Back to before I was diagnosed with MM and the compression fractures. I will be ME again. And I will get to enjoy Brandon a whole lot more than just sitting back and watching him grow. I will be more involved.

To say I am excited about this procedure is an understatement. I am ecstatic! It's been tough sleeping since I found out about this procedure. But I will get rest. I need to get rest before then, because afterwards and after my bedrest, I am sure I will be on the go with Brandon and Eric.