Almost 700,000 spinal bone fractures occur every year, mostly to women over the age of 60 because of osteoporosis, a condition marked by the progressive weakening of bones. While age and gender are risk factors for this condition, other risk factors for osteoporosis include:
- Family history of osteoporosis
- Abnormal absence of menstrual periods
- Anorexic or bulimic
- Lack of calcium in the diet
- Long-term use of corticosteroids or anticonvulsants
- Lack of exercise
- Excessive alcohol consumption
Spinal fractures are considered to be the most debilitating and feared result of osteoporosis. These “compression” fractures are caused when the weakened vertebrae of the spine collapse. When more than one vertebra collapse, deformities like “widow’s hump” occur. Constant pain, limited activity, and reduction in the quality of life are generally the result. Much more difficult to manage than other fractures, spinal fractures can be managed by surgery, but this is risky and should be used only as a last resort.
Vertebroplasty and Kyphoplasty, described below, are two procedures used in the treatment of spinal fractures related to osteoporosis. In some cases, they also may be used where the vertebrae are damaged by cancer.
For many years, reduced activity and pain medications, many of which have problematic side effects, were the only options for relief of pain from spinal fractures. About ten years ago, a minimally invasive procedure called Vertebroplasty was developed with outstanding results. An estimated 75-90% of people treated with Vertebroplasty report complete or significant reduction in pain, and relief is often immediate. Vertebroplasty is an extremely safe procedure with few risks or complications.
During this outpatient procedure, a bone “cement” is inserted to stabilize and prevent further deterioration of the collapsed vertebrae. Early intervention, preferably within the first few months following a fracture, provides the best results. Vertebroplasty may be used in the near future in high-risk patients to treat fragile vertebrae before they break.
Another relatively new procedure, known as Kyphoplasty, restores the collapse in the vertebrae and is used to correct abnormal wedging of the collapsed vertebra. Kyphoplasty prevents loss of height and the “hunchback” that is associated with spinal fractures. It is most effective when performed within six weeks of the fracture.
In this procedure, using CT fluoroscopy, a balloon catheter is (1) guided into the affected area, (2) inflated to the maximum, (3) then deflated and removed (see photo). The cavity created by the balloon is filled with the bone cement that corrects the abnormal wedging and helps restore the spine to more normal alignment.
After Kyphoplasty, people often have less pain and require fewer pain medications. Because they have improved mobility, they have a better quality of life.