I met with Dr. Frank Vrionis, a neuro-oncology surgeon at Moffitt Cancer Center in Tampa Tuesday. The purpose of the meeting: To evaluate the damage done by my multiple myeloma over the years—and to see if vertebroplasty or kyphoplasty might relieve some of my bone and back pain.
According to the site, Bing Health at Bing.com, vertebroplasty is used to relieve pain from spinal compression fractures. After giving a local anesthetic, the doctor inserts a needle into the person’s vertebrae and injects a cementlike mixture into the crushed area. The needle is guided with an imaging technique called C-arm fluoroscopy. The entire process takes 1 to 2 hours, although the actual injection usually takes only about 10 minutes. The cement mixture hardens in about half an hour, and after a short recovery period the person is sent home. Painkillers are often given to the person for the first couple of days.
Taking things one step farther if necessary, kyphoplasty can be used to restore the vertebrae to a more normal shape. The person is given either a local or general anesthetic, and then a small incision is made in the person’s back. A balloon device is inserted into the fractured vertebrae and inflated. Subsequently, a cementlike material is injected into the space created by the balloon. The entire procedure takes 1 to 2 hours for each treated vertebra, and the person may return home that day or perhaps stay in the hospital overnight.
Dr. Vrionis used recent x-rays from a full body scan I had three or four months ago, along with an MRI of my lumbar and thoracic vertebrae taken last week.
The conclusion: A combination of vertebroplasty and kyphoplasty would be an appropriate option for me—and could help relieve some of the pain. Dr. Vrionis added that steroid injections might also help pain caused by my mis-shaped discs—a result of shifting and damage done as my vertebrae deteriorated.
I had two concerns going in. First, would further delay make it more difficult or impossible to do either procedure in the future. The answer was no. At my current rate of deterioration, it would most likely be years until that happens. My second goal was to get an MRI so I had a benchmark for future comparison. It had been three years since my last MRI. I just thought that would be a good idea.
Ironically, my report from the radiologist was far worse following my x-ray bone survey earlier this year. I was surprised—I expected the MRI to show more damage, not less. But my MRI was limited to the thoracic and lumbar regions. Much of the most serious damage is to my ribs, right femur, pelvis and cervical spine in my lower neck. It looks like all of those Aredia (a bisphosphonate) IV’s over the years—along with lots of extra calcium and vitamin D—have helped limit further bone damage. But it is disappointing how little repair is visible. At least my lumbar vertebrae aren’t getting any worse, thank God! I’m already short enough, having initially lost almost two inches in height.
My bottom line: Despite unexpected “stingers” which can shoot down my arms and upper back, a chronically sore neck which limits my activity and can make it difficult to sleep—and let’s not forget my lower back pain—I will most likely wait to undergo the procedure.
As with stem cell transplants, my philosophy is simple: Exhaust less invasive options first. Kyphoplasty will have to wait. That’s OK—it’s great knowing the option is there should I need it in the future.
Feel good and keep smiling! By the way, does anyone have some extra oxycodone I can borrow? Pat