Osteoporosis Video: Diagnosis and Treatment of Painful Spine Fractures

Video presented by Jeffrey M. Spivak, MD

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Video Transcript

Very commonly when a patient has an onset of acute severe back pain, they are worried that maybe they had a fracture and there are a couple of key points in terms of thinking about that – whether you should be worried or not. Certainly if the pain is very immediate or if it follows a wrenching move, like opening a windowsill or something like that, and you have an acute onset of pain, it is a possibility. With the average, everyday patient there is unlikely to be a fracture, but more a muscle sprain. But if an older patient, somebody fifty or older, if you have a history of osteoporosis or weak bone, if you have had other fractures in the wrist from falling down or a hip fracture, then there is a much higher likelihood that could be a fracture of a vertebrae associated with osteoporosis. The other thing it might be, if you are on medications it might be that as well.

If you have the acute onset of low back pain and you were worried that it might be a fracture, it would not be necessary for you to immediately go to an emergency room or something like that. You can give it a little bit of time – take some medicines, some over-the-counter pain medicines to see if things settle down quickly. If within a day or two they don’t, then certainly see your doctor and get an x-ray to be sure nothing new is going on in the spine from a structural standpoint, and that would be a simple x-ray more so than an advanced test like an MRI or something like that. That would not be necessary early on to diagnose a spine fracture.

Osteoporosis Fracture Treatment

If you have been diagnosed with having a fracture, the doctor does tell you you have a vertebral fracture, it is not necessary to do anything invasive in terms of treatment. Most fractures, if they are simple small fractures, will heal. Some pain medicine for a few days to a few weeks may be all that is necessary. If the pain doesn’t get better or if it is so disabling you can’t function, there are certainly options from a minor surgical standpoint to do minimally invasive procedures to help bolster the strength of the vertebrae in order to relieve pain and to prevent any further collapse. We generally recommend if you have been diagnosed as having a fracture and you are not being treated surgically early on, which is common, to have an x-ray relatively frequently over the first few weeks just to make sure things aren’t collapsing in some unacceptable position because many fractures can cause you to bend forward and have difficulty standing up. It can be a progressive deformity if other fractures happen as well and that can have problems with standing and walking, in terms of pain, and can even in the long run result in breathing problems.

If the pain is bad enough to warrant some type of surgical treatment, the two most common types of procedures done are commonly called vertebroplasty or kyphoplasty. Now those are just terms and both of them refer to procedures where through small little needle holes in the skin, cement is injected into the vertebrae.