Spinal compression fractures, resulting from weakening of the vertebral bodies, require a tailored treatment approach based on the duration of symptoms, degree of the compression, and presence of additional injuries. This can range from conservative measures, such as pain medications and rest, to surgical treatments including vertebroplasty and kyphoplasty. These procedures offer a minimally invasive solution to patients suffering from persistent pain due to vertebral fractures.
Initial Treatment
For the vast majority of patients, the initial treatment plan for a vertebral compression fracture involves medication management and rest. Pain medications help alleviate discomfort and promote healing. In some cases, physicians may recommend external casts or orthoses to temporarily restrict the spine’s motions, providing the fracture the necessary environment to heal.
Surgical Treatment: Vertebroplasty and Kyphoplasty
When pain persists beyond several weeks despite conservative measures, or in cases of severe vertebral compression, surgical treatment is considered. Two specific procedures, vertebroplasty and kyphoplasty, collectively known as vertebral augmentation, are commonly used for this purpose. These procedures can be performed under local anesthesia, sedation, or general anesthesia, as required.
In both procedures, a needle is advanced into the fractured bone under X-ray control to inject a biocompatible cement material. During vertebroplasty, the cement is directly injected into the bone, providing immediate support. On the other hand, kyphoplasty involves the insertion of a small balloon into the collapsed vertebral body, which is then inflated. This maneuver helps restore the vertebral body’s height and corrects spinal deformity before cement is delivered into the created cavity. The cement hardens within minutes after injection, providing stability to the fractured vertebra and effectively controlling pain.
Recovery and Follow-Up
Both vertebroplasty and kyphoplasty are minimally invasive procedures, which means recovery is typically quicker and less painful than with traditional open surgery. Most patients can be discharged on the same day. This makes these surgeries suitable even for older patients with poor general conditions and cancer patients who can undergo these procedures without interrupting their chemo- or radiotherapy.
Patients should follow up regularly with their physician to ensure successful recovery and to monitor for any potential complications. Gentle physiotherapy and a graduated return to normal activities are usually encouraged.
In conclusion, the treatment of vertebral compression fractures is a stepwise, patient-specific approach that balances conservative measures with innovative, minimally invasive surgical techniques. With the right treatment and adequate recovery time, patients can expect significant pain relief and a return to their normal activities.
