Spinal Compression Fracture Treatment Options
A compression fracture is a collapse of a vertebra. It may be due to trauma or due to a weakening of the vertebra (compare with burst fracture). This weakening is seen in patients with osteoporosis or osteogenesis imperfecta, lytic lesions from metastatic or primary tumors, or infection.
Along with back pain, spinal compression fractures can also cause:
- Pain that gets worse when you stand or walk but with some relief when you lie down
- Trouble bending or twisting your body
- Loss of height
- A curved, stooped shape to your spine
Treatments include conservative measures such as bracing, NSAIDS and muscle relaxers for 4-6 weeks. Sometimes interventional procedures such as kyphoplasty or vertebroplasty can be considered for early relief.
Kyphoplasty, similar to vertebroplasty, is designed to stop the pain caused by a spinal fracture, to stabilize the bone, and to restore some or all of the lost vertebral body height caused by a compression fracture(s).
During kyphoplasty a small incision is made in the back through which the doctor places a narrow tube. Using fluoroscopy to guide the tube to the correct position, a path is created through the back into the fracture area through the pedicle of the involved vertebrae.
Using fluoroscopy images, the doctor inserts a special balloon through the tube and into the vertebrae and then gently inflates this balloon. As the balloon inflates it elevates the compression of the vertebra and creates a cavity inside the vertebrae, which is filled with a cementlike material called polymethylmethacrylate (PMMA). This material hardens quickly, stabilizing the bone.
The procedure takes about one hour for each vertebra involved. Patients will be observed closely in the recovery room immediately following the kyphoplasty procedure for about 1-3 hours. Patients should not drive until they are given approval by their doctor.
Risks and Side Effects
The potential risks of side effects are very low and include infection, bleeding, allergic reaction, and prolonged increases in pain. Your physician will use x-ray guidance and sterile techniques to reduce these risks, as well as to reduce the risk of nerve damage and spinal headache.