New procedure at Bryan Whitfield helps cure osteoporosis

Published 12:00 am Saturday, January 24, 2004

DEMOPOLIS – A new procedure is being used by a surgeon in Demopolis to give relief to the pain of osteoporosis. The procedure is called kyphoplasty and is being performed by Dr. Lester Littel, a surgeon from Selma, who works out of the Bryan W. Whitfield Memorial Hospital

The problem is found in women, usually over 60-years-old. People often think of the elderly having hip fractures, but vertebral compression fractures are more common, according to the National Osteoporosis Foundation.

“There are forces on the spine,” Littel said. “Usually the patients are bending over and picking up something up. It will actually just mash down.

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“I tell patients it is like a block of styrofoam; it just gets pushed down. It’s not like a bone that breaks in two that you have to set.”

The patient’s bone are thin, he said. “They have very little calcium….When that wedges down in the front it makes the patient bend over.” It causes a humpback effect.

“They actually get where their ribs are touching their pelvis,” Littel said. “They lose their balance. Because of the pressure on their abdomen they can’t eat so they start losing their weight. They don’t feel good. They don’t want to go out in public.

“It is sort of a declining spiral. It’s something we haven’t been able to treat before. We can treat if you want to do some big open surgery and replace the bone, but these people are usually elderly and they wouldn’t survive some big operation.”

Cases in young people are rare, he said, only the result of car accidents or falling off a building.

The new procedure involves the KyphX Xpander(r) Inflatable Bone Tamp developed by the Kyphon company in California. It received FDA approval in 1998. It was developed by a surgeon looking at an osteo fracture. He wanted to set the fracture, and the surgeon came up with the idea of inserting and inflating a balloon. Sixty-thousand of the new balloon procedures have been done since receiving FDA approval.

“The chronic care doctors are used to just giving them (patients) pain pills knowing in three to six months the pain will get better,” Littel said, “but it doesn’t correct the mechanical problem.”

Littel has been performing the 30 to 45-minute procedure for six months.

By using an X-ray image, the surgeon inserts guide wires precisely in the spinal column. When they are happy with the position, they inflate the plastic balloon. The fractured bone fragments are restored to the correct shape. The balloon is deflated, taken out, a tube is left in and bone cement is injected into the cavity.

“When the cement hardens that stops the motion of the fracture, which causes the pain,” he said. “…Their bone is back to normal – no pain – and they have a reduced likelihood of getting another compression fracture.

“…Orthopaedic surgeons like to fix things….It’s the most gratifying surgery I do. All my patients wake up with a degree on post-op pain. We do this under general anesthesia and put them to sleep. They’re in horrible pain; it’s hard for them to get on the operating table.

“…When they wake up they have no pain and they take no pain medicine,” Littel said “…There’s no recovery period.”

Although his primary practice is in Selma, Little said he performs the procedure at the Whitfield hospital due to the fine anesthesia department. “It’s a top notch place,” he said of the Demopolis hospital.

Littel expects to perform 75 to 100 such balloon procedures a year.

The best way to prevent osteoporosis is through medicines introduced in the last five to 10 years women can start taking in their 20’s to prevent hip and compression fractures. “It has been a disease that has largely been ignored because there were no treatments except taking calcium and Vitamin D,” he said.

“Hopefully, in the future, all women will start taking calcium, Vitamin D and these medicines that will strengthen your bone.”

Little is a native of Chattanooga, Tennessee who moved to Selma four years ago.