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 Relieving pain from osteoporosis, targeting tumors and more

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Image-guided procedures encompass far more than unclogging blocked arteries caused by peripheral vascular disease. At Lawrence Memorial Hospital and Melrose-Wakefield Hospital, fluoroscopy (x-ray imaging) helps guide physicians in performing a number of minimally invasive treatments and diagnostic procedures.

Creating an 'internal cast' to fix osteoporosis fractures
Thanks to a treatment newly available at Lawrence Memorial Hospital and Melrose-Wakefield Hospital, patients can now experience fast relief from debilitating pain. Called vertebroplasty, the procedure helps strengthen broken vertebrae (spinal bones) caused by osteoporosis or cancer. Unlike broken bones in the hip, wrist or elsewhere, fractures of the vertebrae are difficult to treat with conventional splints or casts.

"Many people with osteoporosis experience constant pain from a spinal fracture - which severely limits their activity and hurts the quality of their lives," says Julien Vaisman, MD, a pain management physician at Lawrence Memorial Hospital. "Patients see significant relief almost immediately after vertebroplasty. They are able to significantly lower or completely eliminate their doses of pain medication and often become active again."

For vertebroplasty, physicians insert a fine needle through the patient's back, using fluoroscopy to guide it to the fractured vertebra. Bone cement is then injected into the vertebra, which hardens over 20 minutes and stabilizes the fracture, acting like an internal cast.

Helping people with kidney failure
Fluoroscopy also plays a pivotal role in helping many people with kidney failure. If a dialysis patient's vital hemodialysis graft or fistula stops working properly, a nephrologist may refer them to an interventional radiologist for evaluation. The interventional radiologist will insert a small needle into the graft or fistula, inject radiographic contrast material and take digital x-rays. If a blockage or narrowing is found, the interventional radiologist will then perform balloon angioplasty to open the clogged artery.

Precisely diagnosing and targeting tumors
At both Lawrence Memorial Hospital and Melrose-Wakefield Hospital, fluoroscopy guides needle biopsies, which provide fast, minimally invasive alternatives to traditional surgical biopsy. Needle biopsy is most commonly used to evaluate abnormalities in the breast, liver, lungs, thyroid gland and kidneys. For the procedure, a very thin needle is inserted - typically using x-ray imaging for guidance - into the mass to remove cells or fluid to be evaluated for the presence of cancer. At Melrose-Wakefield Hospital, fluoroscopy also guides interventional radiologists in performing uterine fibroid embolization. The procedure eliminates painful, benign tumors in the uterus.

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