In the news

Back together with Bone and Glue

By JANIE HELLSTROM
SPECIAL TO THE PRESS JOURNAL

A few weeks ago, Esther Johnson rested on her stomach in a stark white surgical suite at Lawnwood Regional Medical Center in Fort Pierce as the operating room staff draped all but a small
rectangular area of skin in the center of her back.Johnson was on a translucent surgical table that allowed X-rays to follow the process as her surgeon, Dr. Scott Katzman, inserted a long, metal probe into her spine. She was calm and motionless, but awake under a local anesthetic, as her surgeon watched the probe slowly moving into the area of a fracture in her vertebrae.

Once the first metal instrument was in place, Katzman filled a syringe with surgical cement and, placing it inside the probe, slowly pushed the plunger, releasing the cement into Johnson's back to fill the first of two fractured areas.

On the viewing screen at the foot of the operating table, Katzman and the rest of the surgical team, watched as the cement flowed into the fracture, filling and eventually sealing the area. Then Katzman repeated the procedure on a second fracture. The entire process took only about 20 minutes.

"It only takes a few minutes for the cement to harden," Katzman said, "and the procedure called vertebroplasty gives almost immediate pain relief to patients who may have suffered for years."
Although the procedure is relatively new, Katzman already has performed it about 50 times. He says his experience doing spine surgery as an orthopedist is good training for this treatment because he is able to use both touch and the X-rays to be certain the probe is placed in the correct position before the cement is injected.

Some interventional radiologists also do this procedure, he said, adding that it is done on an outpatient basis in either a surgical suite or radiology suite.
The new procedure was something Johnson was thrilled to learn about and couldn't wait to have performed.

"I've worked in the dental field for 50 years, standing and bending over patients and over models while working in the lab and I still do lab work in my home."

Johnson has had back pain for many years, and it has progressively gotten worse as a result of osteoporosis.

"I've been the primary care giver for my husband for the past five years because of (his) strokes and also cared for his father, who was also a stroke victim, for six years. The pain (in my back) has been constant for at least five years, and I've taken all kinds of medication and worn a back brace to try to get some relief."

Caring for her husband requires her to do a great deal of lifting.

"At times my back bothered me so badly that when I got up in the morning, it was agony just to lift a pot of water to make coffee."

Johnson was convinced that she would have to live the rest of her life with the pain. Also, she recently suffered several falls, including a severe one from a ladder onto a cement floor.

"I would describe my continuing pain as about 7 on a scale of 1 to 10," she said.
On Feb. 13, Johnson had an appointment with Katzman at his office in Fort Pierce. He told Johnson about the new cement procedure and she immediately scheduled it.

"I had long ago ruled out the possibility of back surgery because my husband is severely handicapped and I am his primary caregiver. I simply could not take time to recover from a major back surgery."

Katzman said vertebroplasty has been done in Europe for some time but is new to the United States.

"It doesn't give 100 percent relief to every patient but for most patients, it makes a significant difference in their daily lives and routine."

Two days after her surgery, Johnson said she felt "absolutely wonderful."

Did the procedure bring immediate relief?

"Well, I thought maybe I'd be a little uncomfortable when I went home the day of the surgery and the doctor had given me a prescription for some mild pain medication. He said I could take two pills every four hours.

"I took two pills when I went home because I thought I would still have some pain, but it's been two days and I've only taken half a pill since then. I feel absolute wonderful.
"There's no doubt about it, for me, this was a miracle."

Originally published in the Vero Beach Press Journal (FL)
March 13, 2001