Vertebral compression fractures are a very common type of fracture of the spine which causes one or more of the vertebra, the bones which form the spinal column, to collapse. These fractures tend to occur in females over the age of 60. Women in this age group often have osteoporosis, a weakening of their bones, which predisposes them to these fractures. Patients with bones weakened by cancer are also at risk for vertebral compression fractures.

 

The majority of compression fractures do not cause any pain. People often only notice progressive loss of height and/or a stooped forward or "hunchback" posture. When they do cause pain it is often a severe back pain which tends to begin suddenly during a person's usual activities or is preceded by a minor fall. The pain can be debilitating and can cause a person to become bed-ridden. In addition to this pain, the change in posture, known medically as "kyphosis", may cause decreased appetite and a decrease in lung function over the long term.

 

Vertebral fractures are often diagnosed on x-rays of the spine obtained by emergency or primary care physicians when a patient complains of back pain. The limitation of using x-rays to diagnose these fractures is that these films often do not allow a doctor to determine if a fracture is recent and is likely to be causing someone's back pain, or if a fracture is old and unrelated to a patient's pain. An MRI or a bone scan can be helpful for making this determination.

 

In the past, treatment for vertebral compression fractures consisted of a back brace, pain medications including powerful narcotics, and bed rest. This type of treatment often required weeks to months of waiting with patients having little choice but to endure the pain. The restricted activity required by this treatment also increased patients' risk for complications such as blood clots, worsening of osteoporosis and depression.

 

Vertebroplasty is an innovative treatment for vertebral compression fractures performed by the interventional radiologists at Valley Endovascular Associates. Using x-ray guidance needles are inserted through the skin and into the vertebra. Medical "cement" is then injected through the needles. This is then allowed to harden and the needles are removed. The cement works by hardening the vertebra so that the broken fragments of bone do not move. This relieves or significantly reduces pain immediately in some patients and within 48 hours in most patients. Patients typically go home after a recovery period of a few hours and can resume their usual activities thereafter.

 

 

Kyphoplasty is a newer procedure which is similar to vertebroplasty. This procedure adds an important step: prior to the injection of cement a balloon is inflated within the vertebra to raise the collapsed bone and to create a cavity. Cement is then injected into the cavity and allowed to harden. This extra step restores at least some of the lost height caused by the fracture. It also improves the kyphosis (the abnormal posture caused by the fracture). The recovery period for kyphoplasty is a few hours as it is for vertebroplasty. However, patients are usually admitted to the hospital for an overnight stay for observation.

Click here to view a video describing kyphoplasty in more detail.

 

 

 

 

 

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