Opioid-free treatment

From left, Tahoe Carson Radiology Specialists Keith Shonnard, Shannon Altahus, and Nick Carlevato.

From left, Tahoe Carson Radiology Specialists Keith Shonnard, Shannon Altahus, and Nick Carlevato.

In efforts to overthrow opioid use in the state, one regional physician is providing patients an alternative, safer technique to eliminate pain.

Dr. Nick Carlevato of Tahoe Carson Radiology said Balloon Kyphoplasty — a minimally invasive surgical procedure that repairs compressed bone fractures — brings immediate relief in 80 percent of patients.

However, as a physician at TCR for more than 17 years, Carlevato is concerned the medical center is only capturing about 20 percent of patients in Carson City for this alternative, he said.

“It’s an underrated procedure,” he said. “Some may not realize they osteoporosis or another fracture and other doctors would prescribe pain meds. Then, patients rely on the pain meds for relief but as they get older, things will worsen. It’s a vicious cycle.”

According to a recent study by the Nevada Department of Health and Human Services, opioid-related deaths decreased in the state in 2016, however, hospitalizations for it are still persistent with prescription rates at 87.5 percent.

Carlevato said fractures occur 700,000 times per year in the U.S. from daily activities, especially in seniors. Although the procedure has been practiced for at least 20 years, not many people are aware of its benefits.

A study conducted by the American Association of Neurological Surgeons shows kyphoplasty treatments not only reduce pain but also opioid use.

“A lot of the time, patients are just discovering they have osteoporosis,” he said. “They need to know where to seek proper treatment for that. The procedure we offer improves health, mortality, and relieves pain without having to use opioids.”

Including Carlevato, five physicians at TCR assess and treat about 125 patients per year in the region with the procedure. He said majority of patients are women of ages 60 and over, and suffer from osteoporosis or other fractures due to weak bones.

Dayton resident Cindy Tapp experienced this in September and agreed to undergo Balloon Kyphoplasty when her doctors recommended it.

She said the relief from her fracture after the surgery was immediate and was able to return to work in two weeks.

“It was a fast and quick recovery,” she said. “I was required to go under anesthesia since they put cement in your back but it stopped the pain instantly.”

Carlevato said although the procedure is effective, fractures still need time to heal. He said about 60 to 70 percent of patients walk out with some relief, while 8 to 10 percent have minimal relief.

But even with those results, he said, there are still remarkable improvements from the procedure. For every fracture that isn’t treated—especially in the thoracic spine—the respiratory system decreases by 5 percent, he said, and eventually leads to death if not treated.

“Once it’s done, it fixes the fracture permanently,” he said. “Fractures could happen again but it’s rare. That’s where taking vitamin D, calcium, and other supplements can come into play.”

But for success stories such as Tapp, she said the transformation from pain to peace has been an amazing journey.

“Sometimes, I may need to take aspirin if I over work myself,” she said. “It’s just a matter of time to heal, but the pain is gone.”

With the new state law going into effect January 1 — how medications containing opioids are prescribed to patients and when to pursue disciplinary action against doctors—this procedure could gain its own spotlight in part of Nevada’s fight to defeat the opioid crisis.


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