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Will you be willing to patch up your vertebrae with cement?

Treating patients with osteoarthritis has been a difficult task for doctors to handle. The only option available was either wearing a back brace and waiting to heal or switching over to painkillers. // A new form of treatment called vertebroplasty, in which a form of cement is injected into the broken spinal bone has revolutionized the treatment of osteoarthritis.

Vertebroplasty came to the United States in 1993, when Dr. Mary Jensen and Dr. Jacques Dion, interventional neuroradiologists at the University of Virginia Health System, were confronted with a woman with breast cancer that had spread to her spine. Conventional medicine had nothing to offer the woman for her excruciating, unrelenting pain.

But they remembered a lecture by a French doctor who said she had injected a form of cement into the vertebrae of cancer patients to relieve their pain. Jensen and Dion tried the procedure.

"The next day," Jensen said, "her pain was gone."

The treatment has been found to benefit many. The hot acrylic bone cement may be shoring up the spine or merely destroying the nerve endings that transmit pain. Perhaps the treatment might also have a placebo effect in providing symptomatic relief.

The procedure has been regarded to be harmful in the long run because of the increased possibility of adjacent vertebral fractures.

Kyphoplasty, another form of treatment is becoming increasingly popular and involves inserting a balloon into the vertebra and inflating it to restore the bone's shape before injecting cement.

A number of questions regarding these two forms of treatment remain unanswered. The advantages of the procedure over the others have not been documented and the risk-benefit ratio is yet to be assessed.


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