By Amanda N. Sacino, MD-PhD . Neurosurgeon and Managing Partner
Compression fractures occur in the vertebrae, often caused by osteoporosis, trauma, or other bone-weakening conditions. These fractures can result in pain, loss of height, and decreased mobility. While conservative treatments like pain management and physical therapy are commonly used, some individuals benefit from kyphoplasty, a minimally invasive procedure designed to treat compression fractures. This article discusses the causes, symptoms, and treatment of compression fractures, focusing on kyphoplasty.
What is a Compression Fracture?
A compression fracture occurs when one or more vertebrae collapse, usually due to weakened bone strength. The vertebrae become compressed or “crushed,” causing deformities in the spinal column. These fractures most often affect the thoracic spine (middle back) but can also occur in the lumbar spine (lower back).
Osteoporosis, which weakens bones and makes them more prone to fractures, is the most common cause of compression fractures. In some cases, trauma such as a fall or car accident may cause a compression fracture in people without osteoporosis.
Causes of Compression Fractures
• Osteoporosis: The most common cause, especially in postmenopausal women, older adults, and those with a family history of the disease. Weakened bones are more susceptible to fractures from everyday activities.
• Trauma: Falls, car accidents, and sports injuries can cause compression fractures, even in individuals without osteoporosis, especially when the trauma is severe.
• Cancer: Certain cancers, such as metastatic cancer and multiple myeloma, can weaken the bones and lead to fractures.
• Corticosteroids: Long-term use of corticosteroids for conditions like arthritis and asthma can decrease bone density, increasing fracture risk.
• Other conditions: Paget’s disease, which causes abnormal bone growth, or vertebral infections (osteomyelitis) can also weaken the vertebrae.
Symptoms of Compression Fractures
The symptoms vary depending on the severity and location of the fracture:
• Back pain: Sudden, severe pain, often localized in the back, worsens with movement, sitting, or standing.
• Loss of height: Recurrent fractures can cause noticeable height loss.
• Spinal deformity: Severe fractures can result in kyphosis, or a hunched back.
• Pain radiating to other areas: Pain may spread to the chest, abdomen, or legs.
• Difficulty moving: Patients may experience difficulty bending, twisting, or walking, and in severe cases, weakness or numbness in the lower extremities.
Treatment Options for Compression Fractures
Initial treatment typically involves conservative approaches:
• Pain management: NSAIDs, opioids, or muscle relaxants may be used to alleviate pain.
• Bracing: A back brace can help stabilize the spine and reduce pain.
• Physical therapy: Exercises to improve posture, flexibility, and strength support the spine.
• Supplements: Calcium and vitamin D help improve bone density and prevent further fractures.
• Bisphosphonates: Medications that slow bone loss in individuals with osteoporosis.
If conservative treatments fail or the fracture is severe, surgery may be necessary, such as kyphoplasty.
What is Kyphoplasty?
Kyphoplasty is a minimally invasive procedure used to treat vertebral compression fractures caused by osteoporosis, cancer, or trauma. It aims to reduce pain, restore vertebral height, and improve spinal alignment.
Procedure Overview: Kyphoplasty is performed under local anesthesia with the patient lying on their stomach. Steps include:
1. Needle insertion: A needle is inserted into the fractured vertebra through a small incision, using X-ray guidance for accuracy.
2. Balloon inflation: A balloon is inserted through the needle into the vertebra and inflated to restore the vertebra’s height and shape, creating a cavity.
3. Bone cement injection: Once the vertebra is reshaped, bone cement (polymethylmethacrylate or PMMA) is injected into the cavity, stabilizing the fracture.
4. Recovery: The patient is monitored briefly and can usually go home the same day, with minimal recovery time. Many patients experience significant pain relief within days.
Benefits of Kyphoplasty
• Pain relief: Kyphoplasty can provide near-immediate relief for many patients experiencing chronic back pain due to compression fractures.
• Restoration of vertebral height: The procedure may restore the vertebra’s height and improve spinal alignment, reducing deformity.
• Minimally invasive: With small incisions, kyphoplasty is less invasive than traditional surgery, leading to faster recovery and fewer complications.
• Improved mobility: Reducing pain and stabilizing the spine helps patients regain mobility and independence.
Risks and Considerations
Although kyphoplasty is generally safe, it carries some risks, including infection, bleeding, cement leakage, and nerve damage. However, complications are rare, and the procedure is usually well-tolerated.
Conclusion: Compression fractures are common, especially in individuals with weakened bones from osteoporosis or other conditions. Kyphoplasty offers an effective, minimally invasive treatment for those whose symptoms do not improve with conservative measures. While it may not be suitable for everyone, kyphoplasty can provide significant pain relief and improved quality of life for patients with severe compression fractures.
239-422-APEX (2739)
3530 Kraft Road, Suite 203 • Naples, FL 34105
www.apexbrainandspine.com