Vertebral Compression Fracture Treatment Review

A vertebral compression fracture refers to a break of the vertebral body, most often below the T7 level of the thoracic spine (upper back), and is most commonly caused by weakened bone resulting from osteoporosis. Most vertebral compression fractures result in a loss of more than 15% to 20% of the height of the vertebra.

Fractures in weakened vertebrae can occur in the course of normal physical activities, without significant accident or injury. At the time of fracture, there is often a sudden onset of back pain. When the fracture heals, there is often a residual wedge-shape of the typically square vertebrae (spine bone). Suffering one vertebral compression fracture increases the risk of future vertebral compression fractures, which can cause unwanted side effects such as significant height loss, spinal deformity (kyphosis, or hunchback), and even has the potential to shorten one’s lifespan if left untreated.

Balloon Kyphoplasty Spinal Fractures Treatment

Balloon Kyphoplasty is a minimally invasive surgery that utilizes inflatable balloons and bone cement injections to treat vertebral compression fractures. The goals of the procedure are to reduce severe pain, restore vertebral body height, reduce wedging, provide bone stability and ideally prevent disability and deformity following spinal fractures.

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Once two small incisions are made in the back bilaterally, balloons are guided into the fractured vertebra and then inflated to elevate the fracture, with the goal of returning the vertebral fragments to a more normal positioning and creating a cavity of open space within the bone. The balloons are then removed, and pasty bone cement that quickly hardens is injected under low pressure to fill this void and stabilize the fracture.

For the highest probability of restoring vertebral height, the kyphoplasty procedure should be done as early as possible after fracture occurrence; however, balloon kyphoplasty may still be a treatment option for older fractures that have not healed properly and continue to cause pain. As with any surgery, general surgical risks include a reaction to anesthesia and infection. Risks specific to balloon kyphoplasty although rare could include bone cement leakage, which in most cases is asymptomatic (meaning the leakage did not cause symptoms) but can in rare cases cause nerve injury or spinal cord compression.

Other Spinal Fracture Treatment Options

In addition to kyphoplasty, spinal compression fractures from osteoporosis may be treated with the following:

  • Non-surgical care, such as rest, pain medications, bracing, physical therapy and/or slow returns to mobility, and heat and cold therapy.
  • Another surgery, vertebroplasty, is a minimally invasive procedure that injects bone cement directly into the fractured vertebra without the initial use of a balloon, with the goal of stabilizing the fracture and stopping the associated pain (caused by spinal bones rubbing together). With vertebroplasty, low viscosity, less thick cement is injected under higher pressure than in kyphoplasty. As with kyphoplasty, vertebroplasty carries general surgical risks (such as infection or reaction to anesthesia) and specific procedure risks such as bone cement leakage.

For more in-depth information on vertebroplasty including a procedure description and additional risk information, see Vertebroplasty After a Painful Spine Fracture.