What Are Compression Fractures?Compression fractures of the spine occur when the vertebrae crack causing them to collapse in height which can result in significant and prolonged pain. Most commonly, compression fractures happen in patients with osteoporosis or osteomalacia (softening of the bones), but can also be caused by trauma or certain types of cancer. Typically, the pain and functional limitations caused by compression fractures can be managed by medicines and physical therapy. In patients who do not improve with more conservative treatments there are minimally invasive treatment options available including kyphoplasty and vertebroplasty.
How Are Compression Fractures Diagnosed?Patients with compression fractures usually present with significant pain in the midline of their back centered at the level of the compression fracture. After a physical exam their doctor will usually order spine x-rays which allow doctors to see what vertebral body is fractured and compressed. After a compression fracture is diagnosed the patient’s doctor will usually start them on oral pain medication and may refer a patient to physical therapy. If patients do not improve they may be referred to an Interventional Radiologist for a minimally invasive procedure called a kyphoplasty or vertebroplasty.
How Are Compression Fractures Treated with Kyphoplasty/Vertebroplasty?
If patients continue to have debilitating pain after trying oral pain medications and physical therapy they may be referred to an Interventional Radiologist to discuss minimally invasive treatment options including kyphoplasty and vertebral augmentation. An interventional radiologist will meet with the patient in clinic for an evaluation and to go over treatment options. The interventional radiologist may also order additional imaging studies such as an MRI to further investigate the compression fracture.
Kyphoplasty and Vertebroplasty are both minimally-invasive image-guided procedures that involve putting bone cement into the compressed spinal bones to help stabilize the fracture.
Typically, the procedure is performed as an outpatient procedure under general anesthesia and patients go home the same day. One to two small incisions are made on the back after the correct level of the fracture has been confirmed by real-time x-rays. A long needle is then advanced into the fractured spine bone under x-ray guidance and then a small drill is used to make a hole for access. A balloon is then inserted into the bone and inflated to help make a cavity for the cement to fill and help restore height of the vertebral body. Bone cement is then inserted and allowed to harden. At the end of the procedure the instruments are removed and sterile dressings are applied.
What To Expect After the Procedure
Most patients who have a kyphoplasty/vertebroplasty experience immediate pain relief but results can take up to two weeks. Immediately after the procedure patients are transferred to the recovery area and typically have bed rest for 2 hours. Patients may be sore for 2-3 days after treatment at the needle entry site but most patients do not need treatment for pain. A follow up clinic visit is scheduled for about 2 weeks after the procedure to see how patients are feeling.
If you are interested in learning more about kyphoplasty/vertebroplasty and meeting with one of our physicians, please call 303-602-4150.