Nonsurgical Treatments for the Pain of Spine Fractures Caused by Osteoporosis
For people who have already experienced spinal fractures caused by osteoporosis, there have been few effective treatments available until recently. Now, two safe, nonsurgical, interventional radiology treatments offer hope for those suffering from the pain of vertebral fractures—vertebroplasty and kyphoplasty.
Vertebroplasty is an outpatient procedure using X-ray imaging and conscious sedation. The interventional radiologist inserts a needle about the width of a small straw through a nick in the skin of the back, directing it under fluoroscopy (continuous moving X-ray imaging) into the fractured vertebra. The physician then injects the medical-grade bone cement into the vertebra. The cement hardens, stabilizes the bone and prevents further collapse. This stops the pain caused by bone rubbing against bone.
Kyphoplasty is a slightly more involved technique for treating painful compression fractures of the spine. In this procedure, a balloon is inserted into the collapsed vertebral body and inflated, pushing the bones back to your natural height. Once the balloon is deflated and removed, bone cement is then injected into the cavity created by the balloon to stabilize the bone.
Kyphoplasty is usually performed under sedation or general anesthesia, often with an overnight hospital stay. Your interventional radiologist may recommend kyphoplasty rather than vertebroplasty for treatment of your recent compression fracture, as kyphoplasty has been shown to restore some height to the vertebra involved and may allow the bone cement to be delivered with greater precision.
Benefits of the Procedures
Because vertebroplasty and kyphoplasty are a minimally invasive procedures:
No surgical incision is needed, just a small nick in the skin
No stitches are required
In the case of vertebroplasty, no hospitalization or general anesthesia is required
Most patients report that their pain is gone or significantly better within 48 hours and that they return to normal activity shortly after the procedure. Studies have shown that from 75 to 90 percent of people treated with vertebroplasty will have complete or significant reduction of their pain.
Causes of Spine Fractures
Spinal fractures, also called compression fractures, are caused by a weakening of the bone in the spine. A fracture occurs when the weakened vertebrae of the spine collapse, usually in the middle (thoracic) or lower (lumbar) spine.
In older adults, osteoporosis—a progressive weakening of the bone over time—is the primary cause of spinal fractures. Fractures typically occur in women over the age of 60 who are affected by osteoporosis. Spinal fractures can also occur among younger people whose bones have become fragile due to the long-term use of steroids or other drugs to treat diseases such as lupus, asthma and rheumatoid arthritis.
Symptoms and Diagnosis
Osteoporosis is called a "silent disease," because bone loss occurs without symptoms. People may not know they have osteoporosis until their bones become so weak that a simple strain, twist of the body, bump or fall causes a bone fracture. The most common site of fracture is in the vertebrae, the bones that make up the spinal column.
Initially, the fracture may feel like severe back pain. However, when more than one vertebra collapses, a loss of height or spinal deformities, such as kyphosis or "widow's hump," may result. For some individuals, the fracture stabilizes itself and the pain goes away. But for many, the pain persists because the crushed bone continues to move and break. For many people with osteoporosis, a spinal fracture means severely limited activity, constant pain and a serious reduction in the quality of their lives.
The symptoms of osteoporosis may resemble other bone disorders or medical problems, so always consult your physician for a diagnosis. In addition to a complete medical history and physical examination, diagnostic procedures for osteoporosis may include a family medical history, X-rays, a bone density test and blood tests.
Factors that increase the likelihood of developing osteoporosis include:
A family history of osteoporosis
Postmenopausal or an abnormal absence of menstrual periods
Anorexia or bulimia
A diet low in calcium
Long-term use of corticosteroids or anticonvulsants
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