If you’re over 60, chances are good you know someone who has dealt with a compression fracture in their spine.
Vertebral compression fractures are injuries to the large bony part of the spine that can occur in the presence or absence of trauma.
Most fractures heal over the course of a few months, but the pain is often gone sooner than that. Non-invasive treatment usually consists of active rest, graded exercise in physical therapy, modification of activities which place stress on the vertebrae, and sometimes bracing.
For more severe fractures that aren’t healing properly, patients are often referred to a specialist such as an orthopedic surgeon.
Depending on the individual patient’s needs, they may be offered a treatment option called a vertebral kyphoplasty. In this procedure, wedge-type compression fractures can be addressed surgically by restoring the height of the vertebra with a balloon and injecting a special cement into the bone. The desired outcome for the patient is to decrease pain, speed recovery, and reduce the risk of fractures down the road.
Without intervention, the bone will still heal, but will likely do so in a collapsed position. This predisposes the spine to deviate into a pronounced curve called kyphosis
According to the Academy of American Family Physicians, “Vertebral compression fractures affect approximately 25 percent of all postmenopausal women in the United States. The prevalence of this condition steadily increases with advancing age, reaching 40 percent in women 80 years of age.”
Men are affected as well, at a slightly lower rate.
To learn more about this intervention, I spoke with orthopedic surgeon Dr. Tony Bozzio of Bay Street Orthopedics. Dr. Bozzio sees patients in Petoskey, Charlevoix, Traverse City, and Boyne City.
What exactly is a kyphoplasty?
Bozzio: “A kyphoplasty is a procedure to stabilize vertebral compression fractures that typically occur because of osteoporosis in older patients. When a vertebral compression fracture occurs, it can be spontaneous, due to trauma, or even pathologic meaning there is a tumor or infection in the vertebral body that has weakened the bone to the point of failure which results in a fracture.
“Kyphoplasty involves placing a needle into the vertebral body with x-ray guidance, followed by a balloon that elevates the fractured vertebral body to a more normal height and angulation, followed by bone cement that is inserted into the vertebral body. This restores the normal anatomy of the vertebral body to help prevent being pitched forward, while also providing significant pain relief.”
Is it a new procedure?
Bozzio: “Kyphoplasty has been around since at least 1984, but really gained popularity in the 1990s. As spine surgeons have refined the technique and the indications for the procedure over the years, it has become a commonly performed procedure and is now done in the office setting, which greatly reduces time and cost for the patient. As many spine surgeons and patients know, the pain relief is dramatic, and recently Medicare guidelines have changed to support earlier intervention with the procedure. I try to treat these fractures as soon as possible, typically within a few days so that patients can resume normal activities.”
What type of patient will benefit the most from this procedure?
Bozzio: “Any patient with a compression fracture that is new or still painful will benefit provided they have osteoporosis (thin bone) or concern for a pathologic fracture. MRI is used to find new fractures that appear different from older fractures on imaging. A small biopsy of bone is also obtained during the procedure to look for any possible tumor that could have caused the fracture as well.
What is the recovery timeline like with respect to resuming normal daily activities and things like gardening or golf?
Bozzio: “There are no restrictions following the procedure. Once the bone cement has hardened patients are able to resume normal activities. The risk of future fractures is elevated after a compression fracture occurs. They need to discuss the underlying problem with their primary care physician to ensure their bone health is optimized.”
There is a large body of research that shows that one of the best ways to prevent non-traumatic compression fractures is weight-bearing exercises.
The good news is that it doesn’t take a huge time commitment to reduce your risk. Simply going for a walk every day can reduce the chances of a compression fracture. A few 30-45-minute strength training sessions each week has been shown to be even more effective.
If you need help getting started, be sure to check with your physical therapist for some expert guidance.
