My Broken Back! Vertebral Compression Fractures
My Broken Back! Vertebral Compression FracturesM
ost of us have had a broken bone at some point in our lives. Whether from falling off the playground swing or tripping on some stairs, we instantly know what is wrong. A visit to our local ER usually results in a cast and a prescription to “slow down” until the bone heals. Everyone can see the cast and we may even get sympathy and better seating on the plane or in a movie. After a period of weeks our cast is removed and the bone is healed, a mini miracle of our body’s ability to heal itself.
However, sometimes and injury occurs and the fracture is not so obvious. The pain can be severe, making it hard to stand and even breathe. Finding relief is difficult. Lying down may help, but you can’t stay in bed 24 hours a day. You see your doctor who orders an X-ray and diagnoses the problem: you have a spinal compression fracture. You ask, ”What can I do to heal this?” No cast will help. Pain medications can take the edge off the discomfort but often there are side effects like mental slowing and constipation, which can make the pain even worse. Unfortunately, compression fractures heal much more slowly than other bones in our bodies. The thought of spending months with this kind of pain can be depressing.
Compression fractures are essentially a collapse of the vertebra, the bones forming our spine. Compression fractures can occur from bone diseases like osteogenesis imperfecta or from tumors, but most often are a result of osteoporosis (thinning of the bone). The fractures can occur slowly and may not cause symptoms initially, but they can also occur acutely after a fall or even simply bending over.
When a compression fracture is the suspected source of pain, an X-ray is done to look for the fracture. If a fracture is found that is consistent with your pain, an MRI is the next step to deter-mine if the fracture is new or old. Compression fractures can lead to loss of height, breathing problems, and even early death. The initial treatment of compression fractures is conservative. Rest, physical therapy and pain medication are commonly utilized. However, if the pain is severe or lasts more than 30 days, more advanced treatment may be necessary.
Vertebral augmentation (also commonly referred to as kyphoplasty) can lead to dramatic improvement in pain and function, and can potentially restore some height loss in the bone. Vertebral augmentation is an outpatient procedure done under local anesthetic and IV sedation. With the aid of fluoroscopic imaging, a specialized needle is placed into the vertebral body of the compression fracture and a small cavity is made. Bone cement is then slowly injected to stabilize the compression fracture. After the needle is removed, a simple bandage is all that is needed to close the wound. Patients can experience marked improvement in their symptoms almost immediately. Studies have shown long term improvement in pain and function after vertebral augmentation. There are always risks with any procedure, but with experienced practitioners and newer techniques of vertebral augmentation, risks are extremely small.
Regardless of the method used to treat compression fractures, management of osteoporosis is vitally important in order to help prevent future fractures from occurring. Chronic pain is not normal and the cause should be investigated. Think of all the things you can’t do because of the pain. The sooner the cause is determined, the sooner you will be on the road to recovery and freedom from pain.