| Vertebral compression fractures may occur with | | | | Vertebral compression fractures may occur with |
| major trauma, such as a motorcycle accident, or with | | | | major trauma, such as a motorcycle accident, or with |
| something as insignificant as a sneeze, or stepping | | | | something as insignificant as a sneeze, or stepping |
| off of a curb. With a compression fracture, the bone | | | | off of a curb. With a compression fracture, the bone |
| compressed and collapses into itself, similar to | | | | compressed and collapses into itself, similar to |
| squeezing a Styrofoam peanut between your fingers. | | | | squeezing a Styrofoam peanut between your fingers. |
| How much force it takes to cause a compression | | | | How much force it takes to cause a compression |
| fracture, depends on the quality of the bone. Elderly | | | | fracture, depends on the quality of the bone. Elderly |
| women with osteoporosis have frail, thin bones, | | | | women with osteoporosis have frail, thin bones, |
| which are easily crushed. But even the young strong | | | | which are easily crushed. But even the young strong |
| bone of an 18 year old, will collapse if sufficient force | | | | bone of an 18 year old, will collapse if sufficient force |
| is applied. These fractures may also be caused by | | | | is applied. These fractures may also be caused by |
| metastatic disease, and multiple myeloma, which can | | | | metastatic disease, and multiple myeloma, which can |
| weaken the bone to the point that it simply collapses. | | | | weaken the bone to the point that it simply collapses. |
| A large majority of these fractures are termed | | | | A large majority of these fractures are termed |
| wedge fractures, which refers to the shape of the | | | | wedge fractures, which refers to the shape of the |
| fractured vertebra. The anterior, or front part of the | | | | fractured vertebra. The anterior, or front part of the |
| vertebra, is compressed, and the posterior or back | | | | vertebra, is compressed, and the posterior or back |
| portion maintains its height. But in some cases, when | | | | portion maintains its height. But in some cases, when |
| sufficient force is applied, the entire vertebra is | | | | sufficient force is applied, the entire vertebra is |
| flattened. | | | | flattened. |
| Compression fractures cause the sudden severe pain | | | | Compression fractures cause the sudden severe pain |
| and disability. The compression fracture itself will | | | | and disability. The compression fracture itself will |
| generally cause only back pain, focused at the sight | | | | generally cause only back pain, focused at the sight |
| of the fracture. Occasionally, when fracture | | | | of the fracture. Occasionally, when fracture |
| fragments are forced out of place and begin pressing | | | | fragments are forced out of place and begin pressing |
| on nerves, there may be buttock and lower | | | | on nerves, there may be buttock and lower |
| extremity pain as well. | | | | extremity pain as well. |
| Historically, the treatment for these fractures has | | | | Historically, the treatment for these fractures has |
| been bed rest, and pain medication. Depending on | | | | been bed rest, and pain medication. Depending on |
| how stable the fracture was thought to be, | | | | how stable the fracture was thought to be, |
| sometimes a brace or body cast would be added. | | | | sometimes a brace or body cast would be added. |
| Young people were more likely to survive the period | | | | Young people were more likely to survive the period |
| of immobility. In the elderly population, with multiple | | | | of immobility. In the elderly population, with multiple |
| medical problems, there was a high rate of mortality | | | | medical problems, there was a high rate of mortality |
| from the immobilization. People often had | | | | from the immobilization. People often had |
| complications with pneumonia, blood clots, and loss of | | | | complications with pneumonia, blood clots, and loss of |
| muscle. In many cases, even though the fracture | | | | muscle. In many cases, even though the fracture |
| would heal, people were never able to return to | | | | would heal, people were never able to return to |
| regular activity. | | | | regular activity. |
| In 1998 the first kyphoplasty was performed. This | | | | In 1998 the first kyphoplasty was performed. This |
| new procedure has been shown to restore the | | | | new procedure has been shown to restore the |
| height of the vertebra, and quickly stabilize the | | | | height of the vertebra, and quickly stabilize the |
| fracture. There is almost an immediate reduction in | | | | fracture. There is almost an immediate reduction in |
| pain making it possible to mobilize patients the day | | | | pain making it possible to mobilize patients the day |
| after surgery. Braces or body casts are generally not | | | | after surgery. Braces or body casts are generally not |
| necessary. | | | | necessary. |
| This surgery is performed through a tiny 1/2 inch | | | | This surgery is performed thru a tiny 1/2 inch incision. |
| incision. A large needle is threaded precisely into the | | | | A large needle is threaded precisely into the center |
| center of the damaged vertebra, using flouroscopic | | | | of the damaged vertebra, using flouroscopic x-ray |
| x-ray guidance. Then a balloon is inserted and inflated | | | | guidance. Then a balloon is inserted and inflated in the |
| in the center of the fracture. This pushes the | | | | center of the fracture. This pushes the fracture |
| fracture fragments back out to their original position, | | | | fragments back out to their original position, |
| re-establishing the dimensions of the vertebra, and | | | | re-establishing the dimensions of the vertebra, and |
| correcting any deformity. | | | | correcting any deformity. |
| When the surgeon is satisfied with the shape and | | | | When the surgeon is satisfied with the shape and |
| height of the vertebra, the balloon is deflated and | | | | height of the vertebra, the balloon is deflated and |
| withdrawn. The void that is left is then filled with | | | | withdrawn. The void that is left is then filled with |
| methyl methacrylate, which is the same bone cement | | | | methyl methacrylate, which is the same bone cement |
| that is used to glue prosthetic joint replacements in | | | | that is used to glue prosthetic joint replacements in |
| place. Within minutes this hardens and immediately | | | | place. Within minutes this hardens and immediately |
| stabilizes the fracture fragments. | | | | stabilizes the fracture fragments. |
| Most people are up the next day. If their pain is not | | | | Most people are up the next day. If their pain is not |
| completely resolved, is greatly improved. They are | | | | completely resolved, is greatly improved. They are |
| generally able to return to their normal activities | | | | generally able to return to their normal activities |
| within a few weeks. | | | | within a few weeks. |
| There are risks with any surgery, but kyphoplasty is | | | | There are risks with any surgery, but kyphoplasty is |
| minimally invasive and the risks are considered to be | | | | minimally invasive and the risks are considered to be |
| very low. It is reported that in up to 10% of cases | | | | very low. It is reported that in up to 10% of cases |
| some methyl methacrylate will extrude outside of the | | | | some methyl methacrylate will extrude outside of the |
| vertebra. In most cases this is harmless and does not | | | | vertebra. In most cases this is harmless and does not |
| cause any problems. The American Academy of | | | | cause any problems. The American Academy of |
| Orthopedic Surgeons reports that in 1 case in 10,000 | | | | Orthopedic Surgeons reports that in 1 case in 10,000 |
| this cement may damage or irritate nerves or the | | | | this cement may damage or irritate nerves or the |
| spinal cord. A second surgery may be required to | | | | spinal cord. A second surgery may be required to |
| remove the excess cement. | | | | remove the excess cement. |
| The benefits of this procedure are that it greatly | | | | The benefits of this procedure are that it greatly |
| shortens the time of pain and disability that people | | | | shortens the time of pain and disability that people |
| with compression fractures are forced to endure. | | | | with compression fractures are forced to endure. |
| Because people are mobilized the day after surgery, | | | | Because people are mobilized the day after surgery, |
| it greatly reduces the risk of complications associated | | | | it greatly reduces the risk of complications associated |
| with prolonged bed rest. | | | | with prolonged bed rest. |
| When comparing the risks and benefits of using | | | | When comparing the risks and benefits of using |
| kyphoplasty to treat a vertebral compression | | | | kyphoplasty to treat a vertebral compression |
| fracture. The benefits seem to outweigh the risks, | | | | fracture. The benefits seem to outweigh the risks, |
| and this procedure may be worth considering. | | | | and this procedure may be worth considering. |