Category: Health & Fitness | Issue: January 2021
Today's Science: Solutions for Back Pain What is Kyphoplasty? Does it Relieve Chronic Back Pain? Why are Vertebral Compression Fractures (VCF) important? A vertebral compression fracture is often the first sign of osteoporosis, but they are usually missed by imaging. For example, 86% of VCFs are missed on advanced CT. VCFs are also associated with high rates of death if left untreated. A recent analysis of the entire Medicare data set showed that for patients with a VCF, only 15% will survive 10 years. However, the same analysis showed that kyphoplasty more than doubles the survival rate of these patients. 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 filed 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 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 relive pain by stabilizing the fracture. Improved mobility results because of decreased pain levels. What happens during the Kyphoplasty procedure? -Needle placement - Under IV sedation and using x-ray guidance, a pencil-sized needle is placed through a small (quarter-inch) incision and a working channel is made in the fractured vertebral body. -Cavity created - A balloon is generally used to create a space and to reduce the fracture to more anatomic alignment. -Devices removed - The balloon is deflated, leaving a cavity in the vertebral body. -Fracture stabilized - The cavity is filled with bone cement to stabilize the fracture. Once filled, the incision is closed. -End of procedure - With the process completed, an internal cast is now in place. This stabilizes the vertebral body and provides rapid mobility and pain relief. -The procedure takes about 30 minutes and has a short recovery time, usually a couple of days for most patients. After Kyphoplasty Patients treated with balloon kyphoplasty have significantly better outcomes in terms of pain reduction, quality of life, function and mobility both initially at one month, and throughout the months and years after treatment. 94% have complete or significant pain reduction and 67% have improved mobility. While kyphoplasty is highly effective for improving mobility and decreasing pain in patients with spinal fractures, it does not treat the underlying osteoporosis itself. It's important for your doctor to treat the underlying bone disease (osteoporosis) causing the fractures. This decreases the risk of future fractures and generally makes spinal fractures less frequent. Kyphoplasty vs. Vertebroplasty Kyphoplasty and vertebroplasty are both medical procedures designed to treat pain associated with vertebral compression fractures. The main difference is vertebroplasty does not create a cavity and there is higher likelihood of cement leakage. Kyphoplasty has a significantly lower complication rate compared to vertebroplasty and more than doubles the 10-year survival rate in patients over 65. 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. Reviews Highly recommend! Everyone in his staff is very kind, courteous, professional, and very knowledgeable. I have mild scoliosis that I already knew about, and lower back pain for years. I refuse to take pain meds, as they only mask the problem. The NP suggested a caudal steroidal injection. I just got back from my first one and have no pain so far in my back. I am very impressed with the time they spent on me. I feel a lot better! - Michelle J. Dr. Webb is a miracle. After 10 years of being told there's nothing that will help me, Dr. Webb found and is treating the problem. I feel like I have my life back. Also his entire staff treats you like you matter. I have never left the office wishing there was more time to ask questions. I have always had the opportunity to ask one more question. I would recommend Dr. Webb to anyone. Please, if you have had the same problem call Dr. Webb. Thanks Dr. Webb and staff for giving me hope again and God bless. - Daniel Cook Great experience! Have dealt with pain for years & was able to get relief. Staff is very friendly & I would refer anyone w/ back pain to them. - Sherry T. Our Practice OUR MISSION – is to help you find freedom from pain without invasive surgery or pain medications. We do this by helping our patients optimize bone health and treating the underlying conditions that cause pain. Dr. James Webb & Associates has helped thousands of patients restore mobility to live stronger and healthier lives. 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. Nancy Murphy Intake Coordinator Reesa Bell Claims Specialist Insurance Accepted Medicare Medicaid Tricare Aetna United HealthCare Humana Coventry / First Health Cigna UMR Physicians Mutual OUT OF NETWORK Currently we are out of network with BCBS and Community Care. We will still file your claims, but cannot guarantee payment. Check your plan for out of network benefits. Serving Northeast Oklahoma Dr. James Webb & Associates serves patients from all over Northeast Oklahoma and beyond. Communities include: Bartlesville, Bixby, Broken Arrow, Coweta, Claremore, Collinsville, Glenpool, Grand Lake, Inola, Jenks, Owasso, Sand Springs, Sapulpa, Skiatook and everywhere in between. Kyphoplasty Osteoporosis Management Epidural Steroid Injections (ESI) Medial Branch Block Radiofrequency Ablation (RFA) Bio-Identical Hormone Replacement Therapy (BHRT) Platelet-Rich Plasma (PRP) Therapy SPINE & NECK Vertebral Compression Fracture Kyphosis Sacral Fracture Cervical Spondylosis Thoracic Spondylosis Lumbar Spondylosis Cervical Canal Stenosis Thoracic Canal Stenosis Lumbar Canal Stenosis Cervical Radiculopathy Thoracic Radiculopathy Lumbar Radiculopathy (Sciatica) Lumbosacral Radiculopathy Lumbosacral Spondylosis Degenerative Disk Disease Facet Syndrome Facet Arthropathy BONE & JOINTS Osteoarthritis Degenerative Joint Disease Osteoporosis Osteopenia Vitamin D Deficiency HORMONE Menopause Hypothyroid Hyperthyroid Testosterone Deficiency (low testosterone) Hormone Replacement Therapy Metabolic Bone Disease Metabolic Disease COMMON NAMES Chronic Back Pain Low Back Pain Mid, Upper Back Pain Broken Back Pinched Nerve Leg/Hip Pain Herniated Disc Spinal Tumor Spinal Fractures Dowager’s Hump Hump Back Curved Spine Treatment Options Learn more about our approach to some of the more common treatment options. Osteoporosis Treatment • Vertebral Compression Fracture (VCF) Treatment • Spinal Stenosis Treatment • BHRT Therapy • Back Pain Relief Bone Density Scans