A surgery that makes neurosurgeons happy


Jan. 30, 2009 at 11:03 p.m.
Updated Jan. 29, 2009 at 7:30 p.m.

Sister Lucilla Donnelly was standing on a two-step ladder to put some framing in overhead storage at Incarnate Word Convent in Victoria when the accident happened.

"Coming down I just missed the last step," she said.

The fall left a painful fracture in the retired nun's vertebrae. For several weeks, she had trouble getting up from bed and moving around and she couldn't do any volunteer work.

Now, she feels much better and has resumed many of her daily activities. On Dec. 15, Dr. Christopher Chaput, a Victoria neurosurgeon, performed a surgery on her called, balloon kyphoplasty, which realigned the bone and allowed her to avoid a longer path to recovery.

Chaput has done about 200 balloon kyphoplasties in the last five years. The surgery is unusual because it often produces immediate results, or "instant gratification," he said.

"When a surgeon sees a happy patient, that's a happy surgeon," he said.

Dr. Keith Norvill, another Victoria neurosurgeon, described it as "one of the procedures that we do that has the best results." He has performed about 600 balloon kyphoplasties in the previous five years.

During the surgery, the patient lies face down on the operating table so that his spine is exposed, Norvill said. The patient is placed under general anesthesia for the duration of the procedure. A fluoroscope, or an x-ray machine that can take real time images, scans over the patient's back and exposes the fractured area.

The operating neurosurgeon then inserts a series of needles, typically two for every fracture, into the vertebrae, Norvill said. A deflated balloon passes through each needle and into the location of the fracture, where it is inflated.

"The inflation of the balloon is what pushes the fracture back to normal position," Norvill said.

The neurosurgeon deflates and removes the balloon, Norvill said. The surgeon then puts bone cement on the operated area to keep the realigned vertebrae in its proper position.

Norvill often recommends the surgery, which generally takes 20 minutes, to patients with fractures in their vertebrae. He said it is "minimally invasive" and a better alternative to traditional methods of healing these fractures - wearing a back brace for several weeks or even months.

The average age of his patients who get this procedure is 70, Norvill said. This older age group often suffers from osteoporosis, a weakening of the bone structure that can lead to fractures.

The procedure often relieves pain, improves walking capabilities and enables the patient to return to normal routines, he said.

After this operation there is almost zero recovery, limitation or restriction," he said.

Norvill cautioned that the procedure entailed some risk of infection, bleeding, spinal cord injury, cardiac complications like a heart attack, stroke or even death. Three patients from the Victoria area have died during this operation, Norvill said.

"There is no such thing as minor surgery," he said. "Every surgery has its potential complications and risks."

However, Norvill said the likely benefit outweighed the slim possibility - less than 1 percent - of a complication developing.

"You might likely be lying in bed wearing a brace for three to six months and have some of the same complications just from inactivity," he said.



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