Understanding Compression Fractures

by Graf Hilgenhurst, M.D.

Compression fractures of the spine are the result of a collapse of a vertebra. More often than not, it occurs when there is a combination of bending forward together with downward pressure on the spine. The bone collapses and the anterior, or front part of the vertebral body, forms a wedge shape, leaving the vertebra crushed, or compressed.



Compression fractures can be exceptionally painful and can cause neurological disfunction, such as weakness in the legs and interference in bladder or bowel function.

Causes. Let's look at what causes a compression fracture:

• Osteoporosis. Statistics show that 40% of all women will have at least one compression fracture by the time they are 80 years old. Loss of bone mass, which is very common in post-menopausal women, can cause collapse during even the most mundane of activities, which is why this is one of the most common causes of compression fractures.

• Trauma. Minor and severe fractures resulting from a fall, a car accident, or a forceful jump in which someone lands on their feet or rear, can also stress the spine past its breaking point.

• Metastatic Disease. Pathologic fracture, or disease at the fracture site is another cause of a compression fracture. This most often is the spread of cancer cells from their primary site to other areas in the body, causing destruction and weakening of the bone.

Treatment. Thanks to medical advances, there are now both surgical and non-surgical treatments for compression fractures. Years ago, the only treatment for a broken bone in your spine was pain medicine, rest, and back braces (about which there is a well-known saying: "The inconvenience of the brace is directly proportional to its effectiveness." So you can imagine how uncomfortable braces can be!) Still, in many cases, this is the most bene?cial course of action. However, advances in spinal surgery have made repairing these fractures extremely effective with less pain and a quicker recovery time.



When surgery is required, Vertebroplasty or Kyphoplasty are effective courses of treatment. Each procedure is minimally invasive and serves to stabilize the spine and relieve pain. The procedures are similar in that they each involve a small incision and the insertion of an acrylic bone cement mixture. In Vertebroplasty, the cement is injected into the fractured vertebrae through a hollow needle with the aide of fluoroscopic or image guidance. In kyphoplasty, a balloon is first inserted into the fractured bone through the hollow needle to create a cavity or space, and the cement is injected into the cavity once the ballon is removed.

With both treatments, the cement mixture hardens in about 10 minutes, and acts like an internal cast for the spine. The incision is minimally invasive, requiring very little healing time, and most patients go home the same day.



You can watch a video of vertebroplasty on our website. Simply go to Patient Information and select Treatments Offered. From there, you will look under Pain Management, and Head, Neck and Spine to find the video on vertebroplasty.

Dr. Hilgenhurst is Board Certified in Pain Management and Anesthesiology. His practice, Precision Pain Care, is located in Smyrna, TN.