U.VA. DOCTORS BRING RELIEF TO SOME OSTEOPOROSIS SUFFERERS

	CHARLOTTESVILLE, Va., Dec. 31 -- Doctors at the University
of Virginia are the U.S. pioneers of a procedure that uses a special
cement to reinforce crushed vertebrae and quickly relieve back pain
caused by osteoporosis, a degenerative disease found mostly in older
people which renders bones brittle.
	Dr. Lee Jensen, an assistant professor of radiology, and Dr.
Jacques Dion, a professor of radiology and neurosurgery, are
injecting polymehtylmethacrylate, or PMMA, directly into the crushed
vertebral bodies of osteoporotic patients.  The material hardens and
quickly relieves the pressure on adjoining nerves.
	Many of the patients arrive in the hospital bed-ridden and
on pain-killers, then undergo the procedure -- called vertebroplasty
-- and walk out the next day virtually pain-free, Jensen said.
"Several people are describing it as a miracle," she said.
	Some patients have had multiple vertebrae reinforced.
Garland Whitmer, 70, of Harrisonburg, Va., has had four
vertebroplasties since January 1995, when he suffered an adverse
reaction to morphine, which he had been taking for back pain.
	"I was a total invalid -- I couldnÕt even feed myself," he
said. "Lord have mercy, I couldnÕt get around at all.  I couldnÕt
walk.  By the time I left, I could walk with a walker."
	Dorothy MeadorÕs son saw a television report about the
procedure and said, "ThatÕs my mama! ThatÕs my mama!" He contacted
Dr. Jensen about his motherÕs condition, and the 75-year old
Virginia Beach woman has had three vertebroplasties since Labor Day,
and hopes to have at least one more done in the near future.
	"The ones Dr. Jensen has worked on, I truly think she has
really helped," said Meador, whose surgeon traveled to
Charlottesville to observe her first operation.
	The U.Va. doctors have trained two fellows, who have taken
the procedure to Johns Hopkins University and Tampa General
Hospital.  Dr. Jensen has traveled as far away as the University of
New Mexico to teach the technique.
	In 1993, Jensen and Dion attended a meeting of the American
Society of Neuroradiology, where they saw a presentation on the
technique given by a French physician, Claude DePriester DeBussche.
"The French have been writing about this since 1987," Jensen said.
	By coincidence, when Jensen and Dion returned to
Charlottesville, a colleague asked them for advice on an
osteoporotic patient with a vertebral fracture.
	Dion placed a call to a colleague in France, only to
discover that most of the materials the French used were not
FDA-approved.  The U.Va. duo then experimented with several approved
substances before settling on PMMA, which is used to cement
artificial knees and hips and to replace skull tissue that is
removed in surgery.  They added barium and tungsten primarily to
make the PMMA show up on X-rays.
	Subsequent trials on vertebral bodies taken from cadavers
showed the cement to be three to four times stronger than bone,
Jensen said.
	As of mid-December, the U.Va. doctors had treated 30
patients, repairing 48 fractures.
	Millions of Americans are at risk for osteoporosis, the
weakening of bone structures, with white and Asian women most
susceptible. Vertebral fractures are the second-most common
consequence of the disease after hip fractures: there are more than
538,000 per year in the U.S. Approximately 20 percent of people age
70 or older suffer vertebral fractures each year.
	"The classic patient rolls over in bed and has a sudden
onset of excruciating pain," Jensen said.
	The initial pain can last four to six weeks, during which
time patients have traditionally been directed to rest and take
analgesics. The collapse of vertebral structures can cause kyphosis,
or "dowagerÕs hump," which in turn can lead to breathing and eating
difficulties and depression, Jensen said.
	In vertebroplasty, doctors insert a needle through the
pedicle (bypassing the spinal cord) and into the fractured
vertrebral body.  PMMA is injected 1 cc at a time until it fills the
vertebral body.  The patient lies flat for a few hours after surgery
while the cement sets, then may sit and even stand. In some cases,
no overnight stay is required, Jensen said.
	The only complications patients have experienced so far have
been broken ribs caused by the pressure required to insert the
needle into the vertebral body -- a consequence of osteoporosis,
Jensen said.
	The procedure has also been used on vertebral fractures
caused by tumors that have metastasized to bones, Jensen said, and
theoretically could repair fractured hips.
	Vertebroplasty is not effective for all back pain, Jensen
said, specifically citing muscular and disk pain as examples of
conditions for which vertebroplasty is ineffective.  Even in
patients with osteoporotic fractures, some of the vertebrae may be
too crushed to hold the cement, she said.
	Vertebroplasty costs roughly $5,000, and has thus far been
covered by insurance, Jensen said. That may be a bargain compared to
traditional care methods, which can require three weeks of personal,
skilled care. Jensen cited figures that showed $600 million in
direct costs were associated with vertebral fractures in 1986.
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December 30, 1996
	For more information, contact Dr. Lee Jensen at (804)
924-9719 or Dan Heuchert at (804) 924-7676.  Television reporters
should call our TV News Office at (804) 924-7550.