Treating Vertebral Compression Fractures
There are two procedures available to repair various types of compression fractures of the spine. If you are looking for a minimally invasive procedure, your options are vertebroplasty or kyphoplasty.
Vertebral compression fractures (VCF) are the most common osteoporotic fracture. Low bone density and previous fractures increase VCF's by seventy percent. VCF's are common among breast, lung and prostate cancer patients where cancer has metastasized to the bone.
Years ago, if you had a spinal fracture you went through a procedure where the surgeon would place plates or rods and screws, anchored to the spine to stabilized the fractured bone. This procedure could last 3 hours, or more, while the surgeon cut the back muscles, drilled into the spine and placed the hardware around the fracture.
The physical limitations after hardware placement surgery were numerous, with cautions like, no bending, lifting, twisting, or stretching, and reducing the amount of time you sit, stand and walk. Dressing, showering, sitting, and your daily routine, was extremely painful for many months. Sitting and standing restrictions usually lasted for the first three months post-op since limited sitting is recommended. Driving is prohibited for approximately two to three weeks post-op.
Thankfully, we now have other options to fix these fractures, with greatly reduced recovery time and in some cases, immediate reduction in pain, which has a tremendous affect on your quality of life and length of rehabilitation. There will be some physical restrictions, but they won't be as numerous as the hardware surgery precautions.
Are you a candidate for these types of procedures?
If you've had a recent vertebral fracture, see a Doctor that is specially trained to perform one of these repairs. Vertebroplasty and kyphoplasty work best on new fractures. If you think you have a fracture don't wait to do something about it, especially if you have lost height, or have the forward spinal curve called a widow's hump.
How does the surgeon decide which type of anesthesia is best?
Both procedures can be done with a general or local anesthesia. The type of anesthesia will be determined by your degree of health, risk factors, and age.
What are the similarities and differences between vertebroplasty and kyphoplasty?
With both surgeries a very small incision is made on either side of the spine large enough to insert a small tube, about the size of a pen, to inject bone cement mixed with a small amount of dye. A fluoroscopic X-ray helps to guide the tubing and dye-colored cement into the cavity of the bone to stabilize it, and restore the vertebral height.
With kyphoplasty, a balloon is attached to the end of the tubing, and placed into the fracture and inflated. While this balloon is inflating, it lifts the bone and returns it to the proper position. The balloon is then deflated and removed, creating a space within the bone. The surgeon now has a cavity, created by the balloon, to inject bone cement.
How long will the procedure take?
The surgery usually takes about one hour, and most patients can leave the hospital the same day. In post-op care the surgeon may have you sit, stand and walk to see how steady you are, and if most or all of the pain is gone.
Post operative rehabilitation:
The surgeon will give you a list of exercises to do and a list of things you can not do. Most doctors will order physical therapy so you can be trained in safe movement techniques, posture training, and body mechanics. Most surgeons don't use bracing at this point because the internal fixation with cement is usually enough to keep your spine straight and protect it from the normal external force of walking, sitting and standing.
To find a surgeon near you that does kyphoplasty, contact Kyphon International, or for a specialist in vertebroplasty, contact your local spine clinic.
Click to view the kyphoplasty video from Kyphon International.
Click for an animation on vertebroplasty from Spine Health.