If you've recently been diagnosed with bone loss, fractures are the number one concern. Spinal fractures are very common. Below is an explanation on what they are, how they are diagnosed and how they should be treated.
What is a spinal compression fracture?
Compression fractures cause your vertebral bone and body to collapse, in the spine. This generally occurs in the anterior portion of the vertebra giving it a wedge shape. Multiple compression fractures can occur in more than one area of the spine which can cause a loss of height.
What causes compression fracture?
Spinal compression fractures are a common result of the bone weakening caused by osteoporosis and low bone density also known as osteopenia. These can occur from a simple action like, coughing, sneezing, bending forward, stretching or falls. You may be having small hairline fractures of the vertebra which can turn into a compression fracture from the weakening of the bone during bone loss and injury.
How is this diagnosed?
X-rays are one way to diagnose a fracture of this kind, but many times they won't show up on an x-ray unless the fracture has compressed the bone by 30%. If you are experiencing pain that doesn't resolve, and an x-ray didn't show any damage, ask your health care provider for a MRI or CAT scan. All three of these tests are painless unless lying on a flat hard surface causes additional pain in the area.
How are these fractures treated?
There are several ways to treat these types of fractures which are listed below:
- If the fracture has minimally compressed the vertebra, you may want to let it heal naturally. This will take time, but you won't have to deal with additional pain from a surgery or other type of treatment.
- Kyphoplasty treatment is one way to heal the fracture and restore the height that was lost during the compression. An instrument with a balloon on the end is inserted into the fracture and blown up to expand the area of compression. Once this is done the balloon is removed and surgical cement is put into the area created by the balloon. This stabilizes the bone and its height so it can heal. In most cases this procedure eliminates pain almost immediately.
- Vertebroplasty is similar to kyphoplasty but without using the balloon. Surgical cement is injected into the area. A fluoroscope is used to guide the needle that will inject the cement. A fluoroscope is a live image of the area similar to an x-ray to use to see where the needle will be inserted to release the cement.
- Back surgery is needed at times if the compression is severe and there are complications with nerve impingement. If you have nerve damage, caused by the fracture, an orthopedic or neuro surgeon will need to repair this in most cases. However, this type of treatment is considered a last resort due to complications and extended rehabilitation time.
Kyphoplasty video from House calls T.V.
Is exercise imperative for a successful recovery?
Most insurance companies cover physical therapy (PT) for approximately 6-12 weeks, depending on your needs and doctor's order. If you don't have PT coverage, ask if you can get one or two in-home evaluations and examples of exercises you can do when your doctor orders or recommends it. Exercise is imperative for an improvement in range of motion (ROM) bone healing, reduced swelling and speed in healing. It will take some time to resume your normal activities but PT or exercise is an important stage in the healing process.
What are the best aids for daily living for compression fractures?* ** Reach-its** are important so you don't bend forward during the recovery. You'll need to get things that are on the ground, assist in dressing and retrieving things you may drop.
- Elevated commodes are generally needed to aid in using the toilet. The type that has arms is best, so you can boost yourself up without bending.
- Elevated shower benches are also important so you can sit to shower.
- Long-handled shower brushes are essential so you don't have to bend to wash your legs or back.
- Walkers or canes may also be used until you no longer need assistance with walking.
- Your doctor may order a back brace to support your muscles and protect them and the bone during rehab and recovery.
How long is the recovery process?
This depends on the type of intervention that the doctor uses to promote healing.
It could take several months to recover from kyphoplasty or vertebroplasty. If you choose to let the fracture heal on its own you can expect it to take several months or longer. If you need to have a spinal surgery, recovery can take 6-12 months.
If you suffer from one of these types of fractures, be sure to discuss all of your options with your doctor to come to the best decision for you.
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Spine-health. (4-3-15) Trusted Information for Back Pain. Accessed 4-1-15 from: http://www.spine-health.com/
Pam is a patient educator and digital health writer who has worked for Remedy Health Media on their osteoporosis web site since 2008. Pam is also a group leader and moderator with the National Osteoporosis Foundation Inspire online community.