Vertebral Compression Fracture Management
Vertebroplasty/Kyphoplasty
What is a Vertebral Compression Fracture?
When a bone in the spine collapses, it is called a vertebral (spinal) compression
fracture. These fractures happen most commonly in the thoracic spine (the middle
portion of the spine), particularly in the lower vertebrae of the thoracic spine.
These fractures usually lead to incapacitating back pain, a reduction in your mobility
and often a decline in overall health. By stabilizing the bone (essentially gluing the
fracture back together) this procedure reduces pain and allows a speedy return
to an active lifestyle. 
What are Some Causes of Vertebral Compression Fractures?
Compression fractures of the spine generally occur from too much pressure on the vertebral body. This usually results from a combination of bending forward and downward pressure on the spine.
A common cause of compression fractures is osteoporosis. This disease thins the bones, often to the point that they are too weak to bear normal pressure. The thinning bones can collapse during normal activity, leading to a spinal compression fracture. Spinal compression fractures are the most common type of osteoporotic fractures. These vertebral fractures can permanently alter the shape and strength of the spine. The fractures usually heal on their own and the pain goes away. However, sometimes the pain can persist if the crushed bone fails to heal adequately.
In severe cases of osteoporosis, actions as simple as bending forward can be enough
to cause a "crush fracture", or spinal compression fracture. This type of vertebral
fracture causes loss of height and a humped back, especially in elderly women. This
disorder (called kyphosis or a "dowager's hump") is an exaggeration of your spine that
causes the shoulders to slump forward and the top of your back to look enlarged and
humped.
Trauma to the spinal vertebrae can also lead to minor or severe fractures. Such trauma
could come from a fall, a forceful jump, a car accident, or any event that stresses the
spine past its breaking point.
Another cause of vertebral fractures is a metastatic disease. Metastasis is a term that
refers to the spread of cancer cells into other areas of the body. The bones of the spine
are a common place for many types of cancers to spread. A compression fracture of the
spine that appears for little or no reason may be the first indication that an unrecognized
cancer has spread to the spine. The cancer causes destruction of part of the vertebra,
weakening the bone until it collapses. This is a sign that something going on internally is harming the bones.
What are Some Treatments for Vertebral Compression Fractures?
Vertebroplasty and Kyphoplasty are two procedures performed at the S. Mark Taper Foundation Imaging Center that treat spinal compression fractures. They work by injecting medical-grade bone cement directly into the fractured vertebra. This cement hardens quickly and acts like an internal cast. In some cases a balloon is inserted into the fracture (kyphoplasty) to expand the space before the cement is added. This may help to restore the vertebra to something closer to its pre-fractured height. Franklin Moser, MD, Chief of Interventional Neuroradiology, and Marcel Maya, MD, head our team of imaging physicians, nurses and technologists who specialize in treating spinal compression fractures.
What is Vertebroplasty?
Vertebroplasty is an image-guided, minimally invasive, nonsurgical therapy used to strengthen a broken vertebra (spinal bone) that has been weakened by osteoporosis or, cancer. It is usually successful at alleviating the pain caused by a compression fracture. Often performed on an outpatient basis, vertebroplasty is accomplished by injecting an orthopedic cement mixture through a needle into the fractured bone.
How Does Vertebroplasty Work?
Vertebroplasty is performed under local anesthesia and light sedation, while you lie on your stomach. A small incision is then made in the skin near the spine, and a needle is inserted (Step 1). Biocompatible bone cement will be injected through the needle and into the vertebral body (Step 2a). The needle is removed and the cement is allowed to harden (Step 2b). The small opening is covered with a bandage.
This procedure can take from 1-2 hours (depending on how many vertebrae are treated). You will be required to remain for observation for one to two hours. Typically, patients are then released to go home and resume normal activities within 24-48 hours. In most cases, pain caused by vertebral compression fractures will be gone or diminished within 48 hours. You might experience some discomfort or bruising where the needle was inserted.
