Vertebral Compression Fractures

Approximately 700,000 compression fractures of the spine related to osteoporosis and other conditions occur each year in the United States.

Treatment Options
Fractures of the vertebrae have traditionally been much more difficult to manage than broken bones in the hip, wrist or other locations that can easily be treated with surgery.  Now, however, AAR physicians offer safe, non-surgical  minimally invasive treatments (vertebroplasty and balloon kyphoplasty) for vertebral compression fractures that fail to respond to conventional medical therapy such as bed rest, orthotics, physical therapy, analgesics or narcotics.

These nonsurgical treatments,performed by interventional radiologists using imaging for guidance, stabilize the fracture with an injection of medical-grade bone cement into the vertebral cavity. This reduces pain and can prevent further collapse of the vertebra, which typically leads to the height loss and spine curvature commonly associated with osteoporosis. Vertebroplasty/balloon kyphoplasty dramatically improves back pain within hours of the procedure, provides long-term pain relief and has a low complication rate, as demonstrated in multiple studies.

About Vertebroplasty
In the procedure, a needle is inserted through the skin and into the collapsed vertebra.  A special bone cement used for medical purposes (polymethylmethacrylate) is injected into the bone to stabilize it.  Often, more than one fractured vertebrae can be treated in a single procedure.  Open surgery is not needed because the interventional radiologist is able to guide the needle to the targeted spot using X-ray equipment.

Vertebroplasty is not painful and takes just an hour or two, depending on the number of bones treated.  Usually, the procedure is performed with mild sedation and a local anesthetic to numb the treated area.

Some patients experience immediate pain relief after vertebroplasty.  Most report that their pain is gone or significantly improved within 48 hours.  Many people can resume normal daily activities within hours to days after treatment.

Balloon Kyphoplasty
Balloon kyphoplasty is a minimally invasive treatment that can repair vertebral compression fractures caused by osteoporosis, cancer or benign lesions.  Orthopedic balloons are used to elevate the fractured vertebra and return it to the normal position.  Performed under local or general anesthesia, the procedure typically takes less than an hour for each vertebra treated and may require an overnight hospital stay.  Balloon kyphoplasty has been used to treat more than 180,000 patients worldwide.

In the procedure, a hollow instrument is used to make a narrow incision into the fractured bone.  A small orthopedic balloon is guided through the instrument into the vertebra.  The incision site is approximately 1 cm in length.   Next, the balloon is carefully inflated to raise the collapsed vertebra to the correct position; the balloon is then deflated and removed and a bone cement is injected into the space to stabilize the fracture and hold the vertebra in place.

Fractured vertebra	Balloon is inserted and inflated.	Space is filled with cement.

Who is a Candidate for Vertebral Augmentation?
People who have suffered recent fractures that are causing severe back pain despite standard therapy with rest and pain medications are the best candidates for vertebral augmentation.  Older fractures may be treated, but the procedures are most successful if they are performed within one year of the injury.  These procedures are not used to treat arthritis or herniated disc.

About Osteoporosis
Osteoporosis is a condition in which bones become thin and fragile. Because bone loss occurs without symptoms, people may not know they have osteoporosis until their bones become so weak that a simple fall causes a bone fracture. Fractures may occur in the hip, wrist, or other location, but one of the more common sites is in the vertebrae, the bones that make up the spinal column. Multiple vertebral fractures can result in chronic pain and disability, loss of independence, stooped posture and compression of the lungs and stomach.

Risk factors for osteoporosis include:

• Caucasian or Asian race
• Thin, petite body type and/or excessive dieting
• Family history of osteoporosis
• Early menopause
• Lactose intolerance
• Smoking, or excessive use of caffeine or alcohol
• Estrogen deficiency
• Sedentary lifestyle

AAR provides state-of-the-art bone density testing (also known as a DEXA scan) to quickly and non-invasively measure bone density, allowing for the diagnosis of osteoporosis.