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Vertebral Compression Fracture (cont.)

Vertebral Compression Fracture Surgery

Surgery may be required to prevent the spine from pressing on the spinal cord or to stabilize the vertebra adjacent to the fracture site.

Other Therapy for Vertebral Compression Fracture

  • Percutaneous vertebroplasty: This is a relatively new procedure in which a needle is inserted through the skin of the back by a specialist. A cement or "biomaterial" compound is injected into the vertebra with the osteoporotic fracture. The material (usually methylmethacrylate) hardens, like cement, stabilizing the compressed vertebra. Studies using this technique have shown promise in relieving chronic pain associated with osteoporotic fractures. A similar procedure is referred to as a kyphoplasty if a small balloon is used to restore the height of the compressed vertebra prior to injection of the bone cement.

Follow-up for Vertebral Compression Fracture

Follow the instructions exactly as given by the doctor, and ask questions if you are unsure what to do.

  • Take the medications as prescribed.
  • Apply ice for the first week. A good rule of thumb is to place the ice in a bag, wrap the bag with a towel, and then apply the ice for 15-20 minutes every hour. After the first week, either ice or heat may be applied. Apply the one that makes the injury feel better. Applying heat in the first few days after an injury draws more blood to the injury site, thus increasing swelling and pain.
  • Avoid strenuous and painful activities until approved by your doctor.
  • See your doctor frequently to ensure that the bones are healing.

Prevention of Vertebral Compression Fracture

The most important method of preventing vertebral compression fractures is to prevent osteoporosis.

  • Eat a well-balanced diet.
  • Regular exercise, including weight-bearing and strength-training exercise, has been shown to increase the strength of bone.
  • Stop smoking. Tobacco smoke has been shown to weaken bone.
  • All people at risk for osteoporosis should take calcium and vitamin D supplements.
  • In women past menopause, estrogen replacement therapy is likely indicated to prevent osteoporosis. Medications, such as alendronate (Fosamax) and risedronate (Actonel), have been shown to reduce the development of osteoporosis when taken along with appropriate doses of calcium and vitamin D. They have also shown benefit in decreasing the rate of bone loss in those who already have osteoporosis.
  • If you are on daily steroid therapy for another medical condition, discuss with your doctor methods of reducing the dosage of your steroid medication as possible because decreasing the doses reduces the chance of developing osteoporosis. In some medical conditions that require steroid therapy, other medications may be useful in reducing your steroid dosage.

Outlook for Vertebral Compression Fracture

The back fracture should heal in most cases without problems. However, severe fractures may need surgery to keep the spine in alignment. Also, a pathological back fracture may not heal because cancer may be present.

A person who has a fracture caused by osteoporosis can decrease the chance of further fractures with adequate dietary supplementation (calcium), exercise, and hormone replacement, if indicated.

Fractures causing chronic, severe pain benefit from a multidisciplinary approach that may include the primary medical doctor, an orthopedic or neurosurgeon, physical therapy, and pain clinic referral.

Medically reviewed by Aimee V. HachigianGould, MD; American Board of Orthopaedic Surgery

REFERENCES:

Canale, S. Terry, and James H. Beaty. Campbell's Operative Orthopaedics. 11th ed. Philadelphia: Mosby, 2008.

Longo, Dan, et al. Harrison's Principles of Internal Medicine. 18th ed. United States: McGraw-Hill Professional, 2011.

Wardlaw, Douglas, et al. "Balloon kyphoplasty in patients with osteoporotic vertebral compression fractures." Expert Review of Medical Devices 9.4 (2012): 423-436.


Medically Reviewed by a Doctor on 10/4/2016
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