The vertebrae of the spine can be viewed as bricks that help to hold your body upright. As you grow older, the strength or density of these bricks may diminish. Osteoporosis is a common metabolic bone disease that affects millions of people over age 50. Osteoporosis causes bones to lose their density or strength putting vertebral bones at greater risk for compression fracture.
A vertebral compression fracture (VCF) can be caused by vertebral stress such as from a fall or bump. Sometimes the patient doesn’t remember how or when the fracture happened. However, when a vertebral body breaks or compresses it often is painful. If you suffer a sudden onset of mid or low back pain, it is important to obtain a simple x-ray to determine if you have a vertebral compression fracture, especially if you are at risk for osteoporosis.
Vertebroplasty Treatment for VCF
Vertebroplasty is a very rewarding procedure for pain physicians because it can provide the patient with almost immediate pain relief.
Vertebroplasty involves guiding a special needle cannula using fluoroscopic guidance (real time x-ray) into the vertebral compression fracture and injecting bone cement to quickly stabilize the fracture. Pain relief may be immediate. The procedure can be performed with light anesthesia in an outpatient setting. General anesthesia is not always needed and the patient may be discharged home the same days as the vertebroplasty procedure.
VCF Symptoms
In addition to pain, other signs and symptoms include:
- Loss if height (one of the reasons many older people seem to shrink as they age)
- Kyphosis (or humpback)
- Loss of balance (which increases the risk of falling)
- Neurological symptoms such as numbness, tingling, or weakness*
*Weakness increases the risk of falling and breaking bones
Diagnosis
Our comprehensive diagnostic process includes:
Medical history. Your doctor will talk to you about your symptoms, their severity, and what treatments you have already tried.
Physical examination. You are carefully examined for movement limitations, balance problems, and pain. During the exam, the doctor will evaluate loss of extremity reflexes, muscle weakness, loss of sensation, or other signs of a neurological problem.
Diagnostic tests. X-ray is a common test that can quickly show if a vertebra is fractured. If there is concern about spinal cord damage, a CT scan or myelography is performed. Myelography involves injecting contrast dye into the spinal column to visually enhance the spinal cord and nerve roots.
Nonsurgical Treatment
Most compression fractures can be treated with pain-relieving medication, activity modification, and bracing. Osteoporotic patients, who are not taking medication to control osteoporosis, may be prescribed a drug and supplement regimen to prevent disease progression.
Bracing limits fracture movement and immobilizes the spinal region affected. While braces are not always comfortable or fashion-forward, bracing can help reduce pain. Brace use is discontinued when x-rays show the fracture is stable and healed.
Surgical Treatment
Vertebroplasty and kyphoplasty are minimally invasive surgical procedures performed to treat vertebral compression fractures. Sometimes, treatment involves spinal instrumentation and fusion.
Vertebroplasty and kyphoplasty are similar, but different procedures. Both procedures involve injecting orthopaedic cement into the fracture. A primary difference between these procedures is kyphoplasty uses a balloon, which is inflated, to create a cavity for the orthopaedic cement. Kyphoplasty can help restore lost vertebral body height caused by a compression fracture.
Our doctors prefer to use vertebroplasty as there is no need for general anesthesia.
A severe compression fracture may require spinal instrumentation and fusion. Instrumentation (i.e. screws, rods) and fusion (bone graft) joins two or more vertebrae together, stops movement, and stabilizes the spine.
To Learn More
If you have been diagnosed with vertebral compression fracture, or are interested in learning how about treatment options to manage your pain, please contact our pain management experts at the California Spine and Pain Institute. We would be happy to make an appointment for a consultation and provide additional information about other treatment options.
