Spinal Compression Fractures
Spinal Compression Fractures
Treatment for Spinal Compression Fractures
To prevent future fractures, if osteoporosis has caused a spinal compression fracture, treatment should address the pain, the fracture, and the underlying osteoporosis.
In the last decade, all aspects of treatment have vastly improved. We now have better interventional choices for treating fractures as well as better treatments to prevent future fractures.
The majority of fractures can be treated with pain medication, reduced activity, bone density drugs, and a proper back brace to reduce movement during the healing period. The majority of people resume their normal routines. Some people may require additional therapy, such as surgery.
Nonsurgical Treatment for Spinal Compression Fractures
A spinal compression fracture that is allowed to heal naturally can cause pain for up to three months. However, in a few days or weeks, the discomfort usually subsides dramatically.
Analgesic pain medications, bed rest, back bracing, and physical activity is all options for pain management.
Pain medication. A carefully administered “cocktail” of pain drugs can reduce bone-on-bone, muscle, and nerve pain. You can lessen the amounts of the individual medications in the cocktail if it’s provided correctly.
Pain relief from over-the-counter drugs is frequently sufficient. Paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) are two non-prescription remedies that are indicated. Because of the potential for addiction, narcotic pain relievers and muscle relaxants are frequently provided for brief periods of time. Antidepressants can also aid in the relief of nerve pain.
Modification of activity. While bed rest can assist with acute pain, it can also lead to more bone loss and worsened osteoporosis, increasing your chance of compression fractures in the future. Doctors may prescribe a brief bed rest duration of no more than a few days. Prolonged idleness, on the other hand, should be avoided.
Bracing the back. A back brace, like a cast on a broken wrist, provides external support to limit the motion of damaged vertebrae. A back brace’s stiff design restricts spine-related mobility, which may assist relieve pain. Newer elastic braces and corsets are more pleasant to wear but do not work. There’s an ancient adage that says the brace’s effectiveness is directly equal to its inconvenience. Braces, on the other hand, should be used with caution and only under the guidance of a doctor. Excessive use of braces for lumbar issues might result in muscle wasting and atrophy.
Treatment for osteoporosis. Bisphosphonates are bone-strengthening medications that help to stabilise or recover bone loss. To help prevent further compression fractures, this is an important element of treatment.
Surgical Treatment for Spinal Compression Fractures
Surgery is the next option when chronic pain from a spinal compression fracture persists despite rest, activity modification, back bracing, and pain medication. The following surgical methods are used to treat spinal fractures:
- Vertebroplasty
- Kyphoplasty
- Spinal fusion surgery
Vertebroplasty and Kyphoplasty
These methods for spinal compression fractures need extremely short healing time because they use small, minimally invasive incisions. They also utilise acrylic bone cement, which hardens quickly and thereby stabilises the spinal bone fragments and, as a result, the spine. The majority of patients are discharged the same day or after a one-night stay in the hospital.
Vertebroplasty. This surgery relieves discomfort from spinal compression fractures while also assisting in the stabilisation of the fracture. During this treatment, you will:
- The injured vertebrae are pierced with a needle.
- X-rays aid in the accuracy of the procedure.
- A bone cement mixture is injected into the fractured vertebrae by the doctor.
- In around 10 minutes, the cement mixture hardens.
- The patient is usually discharged the same day or after a one-night stay in the hospital.
Kyphoplasty: This treatment aids in the correction of bone deformities as well as the relief of pain caused by spinal compression fractures. During the procedure, you will:
- A tube is introduced into the injured vertebrae through a half-inch cut in the back. X-rays assist in ensuring the procedure’s precision.
- A narrow catheter tube is inserted into the spine, with a balloon at the tip.
- A cavity is created by inflating the balloon, into which liquid bone cement is injected.
- After that, the balloon is deflated and removed, and the cavity is filled with bone cement.
- In around 10 minutes, the cement mixture hardens.
When you consider how well people respond to these procedures, they are truly remarkable. They’re frequently in excruciating pain that won’t go away. But with two minor incisions, we can take care of something that formerly required a large operation with poor results.
Antibiotics reduce the risk of infection, so we do everything we can to make the operation go as smoothly as possible. A unique x-ray machine also assists us in getting the needle into the bone and ensuring that the cement stays in the bone.
Spinal Fusion Surgery
for Spinal Compression Fractures
For spinal compression fractures, spinal fusion surgery is occasionally done to minimise mobility between two vertebrae and relieve discomfort. The treatment joins two or more vertebrae, holds them in place and prevents them from moving until they have a chance to fuse or grow together.
Metal screws are inserted into the vertebrae through a tiny tube of bone. Metal plates or metal rods are bolted together in the back of the spine, and the screws are attached to them. The vertebrae are held in place by the hardware. This prevents mobility and allows the vertebrae to fuse together. The gaps between the vertebrae are filled with bone grafts.
Fusion of the spine is frequently the last resort. We recommend spinal fusion surgery if the bone is more than 50% compressed in height, if patients are in a lot of discomfort, and if they have experienced difficulties from another spinal operation.
A graft might be made from the patient’s own bone or bone from a bone bank. For the operation, the patient’s own bone marrow or blood platelets, or a bio-engineered molecule, can be used to induce bone formation.
Spinal fusion surgery takes longer to recover from than other forms of spinal surgery. Patients often spend three to four days in the hospital, with the possibility of a stay in a rehabilitation facility. Immediately following surgery, patients are usually required to wear a brace. Rehabilitation is frequently required to regain strength and function. The amount of activity is steadily increased. Returning to normal functionality can take two months or up to six months, depending on the patient’s age and health situation.
Spinal fusion surgery for spinal compression fractures has some disadvantages. It disables the two vertebrae’s natural movement, limiting the person’s mobility. Furthermore, it increases the risk of fracture in vertebrae next to the fusion by putting greater stress on them. Patients may need to avoid certain lifting and twisting activities even after healing is complete to avoid putting too much stress on the spine.
However, if a person has prolonged pain following a fracture and has been extensively treated for osteoporosis, spinal fusion can be highly effective.