Vertebral compression fractures in the spine generally occur when a vertebral body has been weakened due to osteoporosis or the presence of a tumor. When a vertebra is weakened, everyday activities such as lifting a child, bending down to pick something up, or even sneezing can cause a fracture. When these fractures occur, the vertebral body collapses into a wedge shape. Vertebral compression fractures may cause severe back pain, limited mobility, and/or a “hunched-over” appearance due to the change in shape of the vertebral body.
A vertebral compression fracture may heal on its own over several weeks or months. Traditional treatments include bed rest, external bracing, and strong pain medications. However, some patients remain in pain after these therapies and may require further treatment.
Vertebral augmentation, often called kyphoplasty, is a minimally invasive procedure to treat vertebral compression fractures. In this procedure, a cavity is created within a fractured vertebral body and medical-grade bone cement is injected into that cavity. The cement hardens quickly, stabilizing the fracture and strengthening the weakened bone. Most patients experience pain relief following the cement injection.
In some procedures, height restoration of the fractured vertebral body may also be attempted. This is done by inflating a small, medical balloon in the vertebral body. Inflating the balloon creates a cavity and, in some cases, helps restore the original alignment of the spine. The balloon is removed before the bone cement is injected into the cavity.
During the procedure, the patient lays face down on a table and is given medications to provide mild sedation. The skin and underlying tissues are numbed and, under high quality x-ray imaging, a needle is passed carefully into the fractured vertebral body. Depending on the fracture, one or two needles may be used. When the needle is in the appropriate position, a balloon or other instrument is used to create a cavity within the vertebral body and is then removed. After the cavity is created, the cement is mixed and slowly injected into the cavity during constant x-ray monitoring. When the cavity is filled, the needle is removed. For one fracture, the procedure usually takes less than one hour. Some patients have more than one vertebral compression fracture. In these cases, multiple fractures may be treated during the same session.
After the procedure, the patient is allowed to carefully test their mobility. Sometimes an overnight stay in the hospital is necessary, but many patients go home the same day. Most patients experience significant pain relief within the first 1-2 days following vertebral augmentation. Medications may be prescribed following the procedure and should be used only as directed. These include:
- Pain medications – usually reduced over several days after the procedure
- Osteoporosis therapy medications – to prevent further bone loss and reduce the risk of future fractures