Recovering from severe spinal fractures: innovative balloon and cement surgery

Lynn Shetterly is one of more than 10 million Americans who have osteoporosis. Osteoporosis is a disease characterized by thin, brittle bones that break more easily than healthy bones. Osteoporosis is most common in women over 50. In fact, women like Shetterly, 70, have a one in two chance of breaking a bone due to osteoporosis.
Several years ago, Shetterly, who lives in California, had a DXA (dual X-ray absorptiometry) bone density scan that showed her osteoporosis was getting worse.
"My doctors watched my numbers get worse and worse. My T-score dropped to minus 4.9, and that scared the hell out of me," she said, referring to how much bone mass she had lost compared to the average healthy 30-year-old adult.
Shortly after, Shetterly's husband died, and she moved to Mount Pleasant, South Carolina, to be closer to family. She saw a doctor, who prescribed medication to try to reverse her bone loss. After a few years, Shetterly's bone density numbers improved, and she decided to stop taking the osteoporosis medication she had been taking twice a year.
“My brother got sick in California, and I went there to help, and he passed away,” Shetterly said. “I was just tossing and turning on the plane. So when I got home and my back started hurting, I didn’t think it was just back pain, you know? And then it just kept getting worse. Bending over, lifting, everything — the pain just kept getting worse and it wouldn’t go away — it kept getting worse. About four weeks later, I went to the doctor and told him some of the things.”
Shetterly had an X-ray, which revealed two vertebral Compression Fractures (VCFs) in her spine — in other words, broken spines. The doctor then asked her to get an MRI for a more detailed examination. Thor Johnson, MD, an interventional radiologist at the Medical University of South Carolina, reviewed her MRI results.
"I called the primary care physician and said, 'Hey, is your woman in a lot of pain? It looks like she's broken two vertebrae,'" Johnson said. "She said Lynn was in a lot of pain. She couldn't sleep, she had trouble walking, etc. Then the primary care physician referred her to me."
Balloon Kyphoplasty is a minimally invasive procedure used to treat spinal fractures caused by osteoporosis, cancer, or benign tumors. Using real-time imaging, Johnson made two small incisions at each fracture site in Shetterly’s back and used a needle to insert a tiny balloon into each damaged vertebra. He then inflated the balloon to return the vertebra to its original height. Finally, he injected acrylic bone cement into the cavity left by each balloon, creating an internal model to repair each fracture.
Shetterly was amazed by the results of the hour-long outpatient procedure, which has undergone many improvements since it was first introduced in 1998.
Medtronic, a leading medical device company, developed balloon kyphoplasty to relieve pain, restore spinal height, and stabilize spinal kyphosis (VCF). Since first introducing the procedure, Medtronic has continued to develop better balloons, improved cement delivery systems, and additional access tools—technologies that have been shown to reduce radiation exposure to surgeons’ hands. Over the years, studies comparing balloon kyphoplasty to nonsurgical treatments have shown that patients with acute VCF, such as Shetley syndrome, experience greater pain relief and improved quality of life with balloon kyphoplasty than those undergoing nonsurgical treatment.
"As soon as the surgery was done, the pain went away. It was amazing. I feel so much better and I walk around the block more."
"I went for a routine follow-up examination and was shocked when he said, 'You've broken your bone again.'
So, just two months after the first balloon kyphoplasty, Shetterly had another one, which was equally successful. Johnson noted that, unfortunately, this is a common occurrence among patients with osteoporosis and spinal fractures.
“Obviously, the more compression fractures you have, the higher the risk of having more compression fractures,” Johnson said. “So she was unlucky the first two times, but you know she’s had three, so the risk of another compression fracture is very high. I’m trying to prevent her from developing severe kyphosis, which is common in people with multiple compression fractures — I’m basically trying to keep her upright. I want to help her prevent another fracture.”
"I know that without kyphoplasty, I would be hunched over and walking on crutches," she said. "I can't imagine what my life would be like without Dr. Johnson and this surgery."