Vertebral Compression Fracture is a condition that most often occurs in elderly women with osteoporosis. In osteoporosis, the bone is weakened from a lack of calcium and vitamin D in the system and this causes the bone to become porous. When the bone becomes porous it becomes more fragile and then is more susceptible to breakage, even under normal, everyday use.
What are the symptoms of a Vertebral Compression Fracture?
If the fracture occurs in an elderly woman with osteoporosis it may not occur at once but rather gradually over time as the bone weakens. In this case there is often no pain or discomfort with the fracture but there still may be signs of a fracture such as a stooped posture or the appearance of a humped back (kyphotic deformation).
If the fracture occurs suddenly from injury it can be extremely painful, especially if the fracture causes the nerves to be impinged (pinched). In this case the patient may experience pain around the flank from the pinching or irritation of the costovertebral nerves.
How is a Vertebral Compression Fracture diagnosed?
Visible symptoms such as pain, and a recent injury, or a stooped appearance in an elderly person may be indicative of a Vertebral Compression Fracture; however the only way to positively identify fractured vertebrae is by x-ray or MRI.
How do you treat Vertebral Compression Fracture?
If a mild fracture is incurred due to injury, often immobilization and rest will allow the fracture to heal naturally. Often anti-inflammatory medications can be used to reduce pain and short term opioid analgesics can also be indicated for relief as well. In patients with osteoporosis it may be necessary for them to take supplements for calcium and vitamin D to help strengthen and repair the bone. Back braces may also be used to help correct posture to minimize risk of further fractures and provide relief. These braces are called Jewett braces or a TLSO.
Should these treatments fail to provide adequate relief, an outpatient procedure termed a kyphoplasty or vertebroplasty may provide exceptional immediate relief.
What are expectations when a patient opts for a vertebroplasty or kyphoplasty?
Studies show that over 85% of patients receive exceptional pain relief after a vertebroplasty or kyphoplasty. The procedure takes about half an hour, and involves the insertion of bone cement into the fracture under conscious sedation or general anesthesia. Most patients are able to go home the same day, and the risks of the procedure are extremely low.
How is the procedure/treatment performed?
Surgical procedure for fractured vertebrae includes the use of a bone cement. With a kyphoplasty procedure a small balloon is inserted into the fractured vertebra and gently inflated to return the vertebra to its original height. Then the surgeon injects a fast curing bone cement into the vertebra, when this adhesive hardens the vertebra will be stable again (it only takes 20 minutes).
With a vertebroplasty, a balloon is not used and bone cement is injected immediately. Height restoration is not achieved, but pain relief is impressive all the same.
What risk or side effects are there?
There is a slight risk of allergic reaction to the anesthesia used and a possibility of inadequate pain relief. In addition, fractures above or below the procedure can occur as well. Infection is rare.
How successful are they for the relief of pain for the condition?
Patients with mild to moderate fractures caused by injury usually experience a high success rate of pain relief (over 85%); however older women with osteoporosis may not heal or may not heal properly. Discuss with your Colorado pain management doctor what treatment options are best for you.