Bone Cement Surgery and the Need for Bone Stabilization Injections

Regarding the bone cement procedure, the physician prescribed "Bone Stabilization Injection."

Hello Dr.
Chen,
My grandmother has osteoporosis and has been experiencing severe pain due to her long-term kyphosis.
After undergoing vertebroplasty, the doctor mentioned on the day of discharge the option of daily injections of "Bone Stabilization Injection" for a total of six months.
The relatives present agreed to this, but I have a few questions:
1.
If she does not receive the "Bone Stabilization Injection" after the vertebroplasty, will her condition gradually worsen? Is there a necessity for the injections?
2.
Are there any side effects associated with the "Bone Stabilization Injection"? I read online that it may be related to the occurrence of osteosarcoma.
3.
Daily injections seem a bit complicated.
Are there oral medications or alternative methods available?
4.
I found that taking calcium supplements is recommended while receiving the "Bone Stabilization Injection." The doctor did not prescribe any; could you please advise on the recommended dosage of calcium supplements?
Thank you for your assistance, Dr.
Chen!

A Yan, 30~39 year old female. Ask Date: 2016/04/17

Dr. Chen Yongxue reply Orthopedics

1.
Bone stabilization and bone cement injection surgeries are commonly used for patients with compression fractures; the former serves a preventive purpose, while the latter is therapeutic.

2.
The occurrence of osteosarcoma has been observed in mice, but when converted to human dosage, it is approximately 3-60 times higher, raising concerns about carcinogenicity; currently, it is not recommended for use beyond two years.

3.
There are other oral medications available that can prevent the progression of osteoporosis.

4.
Common calcium supplements available on the market can be taken.

Reply Date: 2016/04/17

More Info

Bone cement surgery, often referred to as vertebroplasty or kyphoplasty, is a procedure used to treat vertebral compression fractures, commonly caused by osteoporosis. This surgery involves injecting a special bone cement into the fractured vertebra to stabilize it and alleviate pain. While this procedure can provide immediate relief and restore some level of function, it does not address the underlying issue of bone density loss. Therefore, the use of bone stabilization injections, such as Forteo (teriparatide) or Evenity (romosozumab), may be recommended post-surgery to help improve bone density and prevent further fractures.

1. Necessity of Bone Stabilization Injections: After undergoing bone cement surgery, the necessity of bone stabilization injections largely depends on the patient's overall bone health and the risk of future fractures. If the underlying osteoporosis is not treated, there is a significant risk that other vertebrae may also fracture over time. Therefore, while the surgery can provide immediate relief, it is crucial to consider additional treatments to enhance bone density and prevent further deterioration. In many cases, physicians recommend these injections as a preventive measure to maintain bone health and reduce the risk of subsequent fractures.

2. Side Effects of Bone Stabilization Injections: Regarding the side effects of injections like Forteo, there have been concerns about a potential link to osteosarcoma (a type of bone cancer) based on animal studies. However, the risk in humans is considered very low, especially when the medication is used as directed and for the recommended duration. It is essential to discuss any concerns about side effects with your healthcare provider, who can provide personalized advice based on your grandmother's health history and current condition.

3. Alternative Treatments: If daily injections seem cumbersome, there are indeed oral medications available for osteoporosis that can be considered as alternatives. Bisphosphonates, such as alendronate (Fosamax) or risedronate (Actonel), are commonly prescribed oral medications that help to prevent bone loss and can be taken weekly or monthly, depending on the specific medication. However, the choice of treatment should be made in consultation with a healthcare provider, who can assess the specific needs and preferences of the patient.

4. Calcium Supplementation: Calcium is vital for bone health, especially in individuals with osteoporosis. While the exact dosage can vary based on dietary intake and individual health needs, a common recommendation is to aim for a total daily intake of 1,000 to 1,200 mg of calcium, including both dietary sources and supplements. If your grandmother is not receiving adequate calcium through her diet, a calcium supplement may be beneficial. It’s advisable to consult with her physician to determine the appropriate dosage and type of calcium supplement.

In summary, while bone cement surgery can provide immediate relief from pain and stabilize fractures, it is essential to address the underlying osteoporosis to prevent future fractures. Bone stabilization injections can play a crucial role in this regard, and alternative oral medications may also be considered. Additionally, ensuring adequate calcium intake is vital for maintaining bone health. It is always best to have a thorough discussion with the healthcare provider to tailor a treatment plan that best suits your grandmother's needs and circumstances.

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