Treating Compression Fractures

April 03, 2014

A compression fracture in the spine means that a vertebra in your spine has collapsed in on itself or is cracked. It’s usually caused by osteoporosis (though it can also be caused by cancer and by certain sports injuries) and it’s extremely painful, causing deformity and loss of height. Compression fractures are actually more common than hip fractures and often result in prolonged disability.

Years ago doctors were limited in how they could treat osteoporosis-related spine fractures. Pain medications, bed rest, bracing or invasive spinal surgery were the only options available. Today however there are two very successful therapeutic and preventive treatments for compression fractures—vertebroplasty and kyphoplasty. Vertebroplasty is a minimally-invasive, non-surgical procedure that is designed to relieve the pain of compression fractures and also strengthen the treated vertebrae, enabling patients to regain mobility and independence quickly.

Under general anesthesia, a special needle is passed slowly through the soft tissues of the back. Our special radiology technology allows the position of the needle to be seen at all times. A small amount of orthopedic cement, called polymethylmethacrylate (PMMA), is pushed through the needle into the vertebra. PMMA is a medical-grade substance that has been used for many years in a variety of orthopedic procedures. The cement is mixed with a powder containing barium or tantalum (which allows it to be seen on the X-ray). When the cement is injected it is like a thick paste, but hardens rapidly. Usually each vertebra is injected with the cement on both the right and left sides, just off the midline of the back. This restores the vertebra’s structural soundness and provides reinforcement to allow it to better withstand the body’s weight.

Incredibly, within a few hours patients are up and moving around. Most patients go home the same day!

Kyphoplasty is a newer treatment for patients who suffer from the painful compression fractures in the spine associated with osteoporosis. Imagine a person with some vertebrae that have literally collapsed because the bone has deteriorated so badly. Many of these patients are quite immobilized and can hardly move. Like vertebroplasty, kyphoplasty is a minimally-invasive procedure that can alleviate up to 90 percent of the pain caused by compression fractures while stabilizing the fracture. In addition, however, kyphoplasty can also restore height and reduce deformity by providing what you can think of as support beams that prop the vertebrae back up to their proper height. (This procedure should be completed within eight weeks of when the fracture occurs for the highest probability of restoring the spinal bone to its normal height.)

Depending on the case, kyphoplasty is performed under either local or general anesthesia. Using image guidance X-rays, two small incisions are made and a probe is placed into the vertebral body where the fracture is located. The bone is drilled and a balloon is inserted on each side. These balloons are then inflated with contrast medium (to be seen using image guidance X-rays) until they expand to the desired height. The spaces created by the balloons are then filled with PMMA, the same orthopedic cement used in vertebroplasty, binding the fracture. The cement hardens quickly, providing strength and stability to the vertebra, restoring height and providing much-needed pain relief.

Like vertebroplasty, patients who receive kyphoplasty treatment usually go home the same day. Patients can quickly return to the normal activities of daily living and in many cases can regain activities they had lost due to the pain of their condition.

The need to take care of our spine is somewhat hard to appreciate until something goes wrong and we suddenly realize how vital this part of our body is to almost every movement we make. Because the nerves in our body travel through our spine before branching out to the farther reaches of the limbs, compression fractures in the spine can create intense nerve pain that can radiate to different places in the body as well as causing pain in the back itself. People who suffer from osteoporosis continue to treat their condition even after vertebroplasty or kyphoplasty treatment, to prevent future problems.

At Providence Little Company of Mary Medical Center Torrance, we perform many vertebroplasty and kyphoplasty procedures with great success, providing pain relief and increased mobility to many people in the South Bay. Dr. John Jordon is a neuroradiologist at Providence Little Company of Mary Medical Center Torrance. For more information on compression spinal fracture procedures, call us at 1.800.618.6659.