Category: Health & Fitness | Issue: November 2020
Is it too late? Solutions for Back Pain Kyphoplasty Case Study In 2004, Marvet's life was dramatically changed after a life altering auto accident. She suffered from multiple broken vertebrae, broken neck, shattered left forearm and head lacerations. Marvet was used to living a highly social lifestyle; working in a busy office, taking care of family and friends, exercising and enjoying life. Later, as her life progressed, her life came to an altering halt. The pain she was experiencing progressed too; and her problems were exacerbated by osteoporosis. She had surgeries. Prescriptions and pain medicines worked less and less. Doctors and specialists were out of ideas on how to help her other than by using pain medications. By 2014, Marvet, described herself as going into a hole. At this point she was wearing a back brace full-time; she mostly consigned herself to stay home. "Walking across a room was excruciating. I gained weight and was fully depressed," said Marvet. "The last straw was when she took a fall." In more severe pain than ever, she said, "I tried my best to find self-help and discontinued all pain medications." January, 2015, Marvet's husband heard about Dr. Webb's osteoporosis treatments while listening to the radio. "We called Dr. Webb's office for an appointment. He immediately sent me for an MRI, checked my bone density, and calcium. My diagnosis was 7 fractures. My treatment began two weeks later. It was so nice to be treated so well. I finally had people around me who understood what I was going through and helped me. My pain relief from my fractures came within about two weeks after beginning my kyphoplasty and osteoporosis treatments. The treatments are done in stages over a period of time. It has been worth it to drive an hour to see Dr. Webb." Why Marvet like Dr. Webb: "I trust him. He and his staff treat me with great respect and dignity. I have found more help here than any other place over the years of suffering." What is Kyphoplasty? Kyphoplasty is a minimally invasive procedure that quickly repairs vertebral compression fractures (VCF) and restores structural integrity to broken vertebral bone. Kyphoplasty is an outpatient procedure that uses a cavity creation device (usually a balloon) to create a space in the broken vertebra which is then filled with a special bone cement to stabilize the fracture and reduce pain. How does Kyphoplasty help? The goal of kyphoplasty is to restore the broken vertebra to a more normal height and to fix the pain caused by the fracture. When a vertebral fracture occurs, it most commonly presents as an acute worsening of chronic lower back pain. Many times the patient's chronic back pain is getting worse, but it's actually due to a recent fracture. Many of our patients experience immediate pain relief following kyphoplasty. It can help relieve pain by stabilizing the fracture. Improved mobility results because of decreased pain levels. Dr. Webb - Kyphoplasty Expert When it comes to kyphoplasty, Dr. Webb is one of the most experienced physicians in the US. Dr. Webb has performed thousands of kyphoplasty procedures and has the experience necessary to safely perform kyphoplasty. In fact, he also teaches other physicians how to safely and effectively perform the procedure. Here are a few facts about Dr. Webb's kyphoplasty expertise: • He performed over 120 kyphoplasties during his training (fellowship). • Was one of the first physicians to perform kyphoplasty in Oklahoma. • Was a principal investigator in the EVOLVE trial, the largest ever on-label study of kyphoplasty in Medicare patients with vertebral fractures with 350 patients enrolled over 24 sites across the US. • The first in Oklahoma and one of a few in the nation to establish a full-service outpatient clinic focused on medically treating the underlying causes of osteoporosis in patients with VCF. • The highest level of experience in the Tulsa area with 300-400 fractures treated per year. • Continues efforts to refine vertebral fracture treatment, consulting for numerous medical device companies and teaching other physicians how to perform this life-saving procedure. Dr. James Webb and Associates 'We've Got Your Back'
Dr. James Webb, M.D. Dr. James Webb is a musculoskeletal radiologist who specializes in osteoporosis treatment and interventional pain management in Tulsa, Oklahoma. Dr. Webb started his practice as a clinical radiologist to fill a gap for osteoporosis patients who suffered from vertebral compression fractures. As a fellow at the University of Oklahoma, he was trained to perform kyphoplasty, a safe and effective procedure to fix pain from symptomatic vertebral fractures. After seeing a near perfect success rate in bone repair and pain reduction with this procedure, he quickly saw a problem. Patients would get their fractures fixed, but the underlying causes for osteoporosis were not being treated. In 2006, Dr. Webb started what would be the first comprehensive clinic treating vertebral compression fractures and the underlying condition of osteoporosis that causes these fractures. Dr. James Webb & Associates is focused on pain intervention and supporting long-term bone health to reduce patients’ risk for getting fractures in the future. Dr. James Webb is a Board Certified Radiologist as well as a Clinical Instructor at the OU College of Medicine. Non-Surgical Pain Relief Our Unique Approach We do the best for our patients by following the basic principles that we were taught in medical school. Primarily, that the key to diagnosis is in the history and physical examination. The answer for the cause of a patient’s problem almost always lies in what the patient tells the doctor and what the doctor finds when the examine the patient’s body. By following these principles, we are often able to find the source of pain, even when others have not. After that, we employ a systematic approach based on the scientific method, identifying and treating individual components of the patient’s pain. Most spine specialists focus on the intervertebral disc, presuming that a torn, bulging or herniated disc is the main source of the patient’s symptoms. Too often, an MRI is treated as a perfect test. However, the accuracy of MRI–like any other test–is limited. While disk pathology is very common, just because a patient has a disk bulge or herniation, that doesn’t mean that’s what’s causing the pain. For example, in ‘normal’ patients with no back pain, studies have shown that about 50% will have a ‘significant abnormality’ on MRI. When it comes to spinal fractures, MRI isn’t any better. About half of moderate and severe vertebral compression fractures are missed on radiology reports (Hurxthal, 1968). While we may think that radiologists would be the best doctors to pick these fractures up, a study in 2006 (Casez et al) showed that general internists actually recognized more fractures than radiologists after a short training program. For the patients we see, the pain is usually caused by multiple problems that may include the facet joints, the vertebral bodies, posterior elements, sacroiliac joints, muscles and other soft tissues in addition to the disc. Since all of these structures are stacked in the spine like an accordion, they can all be affected when muscle spasm puts pressure on the back (a process known as “axial loading”). We don’t just treat the disc, we treat the patient after doing our best to determine the main source of the pain using our training and expertise. We believe that treating a patient should start with arriving at an accurate diagnosis. Since spinal pain is complex, this isn’t always possible. However, by analyzing all the available data from the history, the exam, imaging studies and synthesizing it into a cohesive, logical explanation for the patient’s problem, we can start a process of elimination. Once a rational diagnosis is made, treatment can begin. Many times, when a patient has back pain, the question is “does this patient need spine surgery?” What we try to do is get to the root cause of the patient’s pain and find out what is most likely wrong with them – not to focus whether or not they are a candidate for a particular procedure. Back pain is a leading cause of disability. Back surgery takes months to recover from, leaves a huge scar and metal in your back. While there are many patients who need and benefit from a surgeon’s procedure, try to help patients avoid surgery when we can. That comes from years of helping patients with pain who still had pain after back surgery and those who couldn’t have surgery because of age or other medical problems.