The spine is composed of a long column of stacking bones, called vertebrae. A fracture or break in a spinal vertebra can cause the area of bone to collapse, causing a vertebral compression fracture.

Usually the front of the vertebra breaks and collapses, while the back of the vertebra remains stable, causing a wedge in the affected area of bone. The collapsed vertebra can put pressure on the spinal nerves.

According to the Society for Interventional Radiology, about 700,000 spinal fractures occur annually. The most common cause of the condition is osteoporosis. It can also be caused by a sudden fall, injury or excessive pressure on the spine. A sudden break in the bone may cause severe pain in the back, legs or arms. If the collapse occurs gradually (the bone continues to thin from osteoporosis), there may be little pain until the bone actually breaks.

Treating Spinal Fractures: Vertebroplasty

Traditionally, doctors use pain medications, physical therapy and braces to help patients with pain from spinal fractures. When these treatments don't help, the patient may be referred for a procedure called vertebroplasty.

With the patient under sedation, doctors use X-rays to guide a hollow needle through the back and into the fractured vertebra. Next, a special bone cement containing polymethylmethacrylate is injected into the vertebra. The cement contains a radio-opaque powder which allow doctors to "see" the cement on X-ray as it fills the space. Once in place, the cement hardens in about ten minutes, providing more stability for the spine (like an internal splint). The cement remains in the body permanently.

After the procedure, patients can quickly return to normal activities. Since many patients needing vertebroplasty have osteoporosis, they receive information on protecting bone health and reducing their risk for future fractures. Vertebroplasty can be repeated in other sections of the spine if necessary.

Vertebroplasty is usually a very safe procedure. However, there is a minor risk of infection, bleeding or increased back pain. Doctors must also carefully watch the cement as it is being injected into the body. If any of the cement leaks into the spinal canal, it can lead to numbness, tingling or even paralysis.

Kyphoplasty

Vertebroplasty can successfully eliminate pain in many cases with spinal compression fractures. However, the procedure simply supports the spine and doesn't restore height loss. For that, doctors may turn to a technique called kyphoplasty.

In kyphoplasty, surgeons first insert a balloon-tipped catheter into the vertebra. A high-pressure liquid is passed into the balloon, causing it to inflate. As the balloon expands, it lifts the vertebra and creates an open space. The cement is then injected into the cavity. Kyphoplasty provides a little more height restoration that vertebroplasty and may be a better option for certain patients, such as those with very severe fractures or spinal tumors.

SOURCES

American Academy of Orthopaedic Surgeons, http://orthoinfo.aaos.org