A spine fracture occurs when one of the bones in the vertebral column breaks or compresses. This typically results in sudden and severe back pain which is out of proportion to the activity that caused it. The pain usually persists for weeks or months and may be disabling. Sometimes the pain is attributed to a muscle pull or strain. Standing or sitting usually worsens the pain; lying down may relieve it. Spinal fractures (or vertebral compressions) are very common, typically becoming more frequent with aging. It is estimated that 700,000 vertebral compression fractures occur in the United States each year. About two-thirds go undiagnosed, and even fewer are treated. One in two women and one in four men over the age of 50 will have an osteoporosis-related fracture in his or her lifetime. Traditional treatment for spinal fracture has been bed rest with pain medication. However, medical advances now offer a proven, minimally invasive procedure that can repair the fracture, relieve the pain, and allow you to resume your normal activities. This minimally invasive procedure is called balloon kyphoplasty. Our physicians (VIRA) have performed thousands of these kyphoplasty procedures over the last decade with excellent results. The procedure is performed under conscious sedation (twilight sleep) or general anesthesia, so you do not experience pain during the procedure. If you or your doctor thinks you may have a spine fracture causing your pain, we will be happy to schedule a prompt appointment in our office to determine the cause of your pain and if the kyphoplasty procedure is appropriate for you. We understand how the pain can severely affect your everyday activities; therefore, we can usually see you in consultation and treat your fracture within days of your calling our office.
Symptoms, Causes, and Consequences of Spine Fractures
There are 33 square or box-shaped bones in your spinal column which enable you to stand upright and protect your spinal cord. Each bone or segment is referred to as a vertebra. There are seven vertebra in the cervical region or neck, twelve in the mid back or thoracic region, five in the lower back or lumbar area, and nine in the sacrum/coccyx or tailbone. Behind these vertebrae, additional bone extends out to form a ring (like a napkin ring) that encircles and protects your spinal cord. Between each segment or vertebra is a disc that is a tough rubbery tissue that cushions the vertebra and allows movement of your spine.
When your bones are healthy, it takes considerable force to break them. However, certain conditions such as osteoporosis with aging, cancer, and long-term use of steroids can make the bones in your spine more fragile and more likely to break or fracture. Most people are unaware that their bones are losing mass or becoming brittle until they experience a fracture. The fracture may be caused by something as simple as picking up a bag of groceries. The resultant pain may severely limit activity and impact quality of life. People with a spine or vertebral fracture are much more likely to develop additional fractures in the future. These fractures can result in loss of height and spinal deformities such as kyphosis (forward curvature of the spine) or so-called dowager’s hump. Just one spinal fracture that remains deformed shortens the spine and pushes it forward, adversely affecting spinal movement. Each additional fracture increases spinal deformity. This change in alignment can compress your internal organs and affect breathing, eating, and digestion. Altering your posture can put additional strain on your back and joints. Aside from the pain associated with vertebral fracture, additional long-term health problems include decreased mobility and decreased lung function. In addition to relieving the pain from spinal fracture, balloon kyphoplasty can help correct the spinal deformity.
Osteoporosis is a disease where loss of bone mass (total amount of bone) and loss of bone quality (how the bone is structured) make you more likely to fracture. Osteoporosis is the leading cause of vertebral fracture. Osteoporosis has several causes. With aging, our bones weaken as a result of decline in ability to absorb calcium and produce vitamin D, as well as decrease in certain hormones which help maintain bone strength. Bone health can also be affected by many diseases and certain drugs. Risk factors for developing osteoporosis include aging, female gender, genetics, certain medications, diet, and lifestyle. You can be tested for osteoporosis, and treatment options include exercise, diet, and medications.
Aside from osteoporosis and steroid use, spine/vertebral fractures can be caused by certain types of cancers. Multiple myeloma is a type of cancer that primarily affects bone and frequently causes compression fractures. Cancers of the breast, lung, and prostate weaken and destroy bone and can cause fractures. These can be treated with the kyphoplasty procedure as well.
Balloon Kyphoplasty Procedure
Balloon kyphoplasty is a minimally invasive procedure used to repair spine or vertebral compression fractures caused by osteoporosis and cancer. Before the kyphoplasty procedure, we will meet with you and examine you, as well as review appropriate tests to determine if the procedure is appropriate for you. Balloon kyphoplasty can be performed under local (conscious sedation) or general anesthesia, whichever is appropriate for you. It can be done as an inpatient or outpatient. The procedure is performed using special x-ray guidance with placement of two needles or cannulas into the vertebral body through tiny incisions in the back. Through these hollow needles, orthopedic balloons are inserted and inflated in the bone. This helps restore the height and correct the deformity and also produces a cavity for injection of medical-grade cement which acts to stabilize the fracture. Most patients report almost immediate relief of pain which improves over the next several weeks.
As with any procedure or surgery, there are some associated risks, although these are minimal in qualified hands. We will discuss these with you at the time of your appointment.
In addition to fracture of the vertebral bodies, the sacrum is also prone to fracture under certain conditions, especially in the elderly. The sacrum is an important bone within the body as it is the bone which supports the vertebral column to the pelvis. Fractures of the sacrum can be severely disabling, rendering the patient essentially bedridden for months. This immobility and lack of movement can lead to additional significant medical problems such as deep venous thrombosis and pneumonia, particularly in the elderly. VIRA also specializes in treatment of these sacral fractures, so-called sacroplasty.
If you or your doctor has diagnosed you with a spinal compression fracture, or if you feel you have recently experienced a fracture, we will be glad to meet with you to determine if you would benefit from balloon kyphoplasty treatment.