Causes and Symptoms of Spinal Compression Fracture
Nearly a quarter of all women, and more than 5 percent of all men over the age of 65, have osteoporosis. People with osteoporosis have a loss of bone mass, leading to weakened bones, putting them at increased risk for bone fractures. In fact, the largest cause of spinal compression fracture (or vertebral compression fracture) is osteoporosis. Because of weakened bones with this condition, a spinal compression fracture caused by osteoporosis can occur from even a minor trauma, such as after a fall or a simple daily activity that includes twisting or lifting.
Although spinal compression fractures are much more common for women (due to higher rates of osteoporosis), they are still a significant fracture risk for older men. Additionally, those with certain types of cancer that weaken the bone can be at risk for developing spinal compression fractures. People with healthy spines can also experience a spinal compression fracture, generally through severe trauma, such as from a sports injury, car accident, or major fall.
In a spinal compression fracture, the vertebral bone has decreased in height, losing generally between 15 and 20 percent of its total height after the collapse of a bony block or vertebral body. They occur more commonly in the middle part of the spine (thoracic region) than in the lower back.
Symptoms of a spinal compression fracture usually include acute back pain, possibly leading to chronic pain if the fracture is not treated. People who have experienced a spinal compression fracture may also find their spinal mobility more limited. Pain may increase when walking or standing, and decrease while lying on the back.
Although general back pain is one of the most common complaints—more than 80 percent of adults have suffered from some form of back pain—if you experience the symptoms above, you may want to consult a spine specialist at the Chicago Center for Orthopedics at Weiss to determine if you have a spinal compression fracture. Untreated, a spinal compression fracture can lead to loss of height, development of a deformed spinal curvature or stooped forward posture, and it can even cause crowding of internal organs.
Diagnosis and Treatment for Spinal Compression Fracture
To diagnose any serious back pain complaint, the spine specialists at Weiss may recommend imaging tests, including X-rays, dual-energy x-ray absorptiometry (DEXA) scans, computed tomography (CT) scans, or magnetic resonance imaging (MRI). These tests can help your doctor make a proper diagnosis, by showing the vertebrae structure, alignment, and any fractures or degeneration.
If your doctor diagnoses a spinal compression fracture, there are some non-surgical treatments that can be explored, including over-the-counter pain relief medications such as anti-inflammatory drugs or acetaminophen, prescription muscle relaxants, or opioid medications for very acute pain. Spinal support through back bracing and physical therapy are sometimes prescribed.
Many people find that conservative treatments do not fully relieve back pain, limited mobility, or deformity caused by a spinal compression fracture, but the idea of spine surgery can seem intimidating. Fortunately, minimally invasive kyphoplasty has made the need for invasive spine surgery for spinal compression fracture less common.
The specialists at The Chicago Spine Center at Weiss are experts in minimally-invasive spine surgery for a number of conditions. Dr. Thomas McNally, the Medical Director of The Chicago Spine Center, is a highly experienced, board-certified spine surgeon who has published multiple medical articles and presented research on the use of minimally-invasive kyphoplasty.
How is kyphoplasty performed?
In a kyphoplasty surgery for a spinal compression fracture, the surgeon uses X-ray guidance to insert a needle in the collapsed vertebra and places a balloon which inflates to increase the height of the collapsed bone. Acrylic bone cement is then injected into the balloon. It hardens within minutes, providing stabilization and permanent support, restoring height to the fractured vertebra.
Kyphoplasty may be performed under general or local anesthesia and takes about an hour. If multiple vertebrae are affected with compression fractures, the surgery generally takes about an hour per fracture treated.
What is recovery from minimally-invasive kyphoplasty like?
People are often surprised to discover that recovery from kyphoplasty surgery is relatively quick. Many patients can be released from the hospital same-day, while others are discharged the day after the procedure.
Following kyphoplasty, most patients are able to walk about an hour after surgery. Sometimes a back brace will be prescribed for a short period of time, but many daily activities can be resumed after discharge from the hospital. Patients shouldn’t drive until they get approval from their surgeon, and their surgeon may limit other strenuous activities following surgery for four to six weeks. As with any surgery, you should discuss all recovery activities with your doctor. For the majority of patients of minimally-invasive kyphoplasty, physical therapy following surgery isn’t needed.
If the spinal compression fracture was initially caused by osteoporosis, patients should consult with their doctor on a treatment plan following surgery, to minimize the risk for future compression fractures, and to limit further bone loss. Your doctor may prescribe bone-strengthening medications (called bisphosphonates) to stabilize and strengthen bone density.
What are the risks of kyphoplasty surgery and what are the success rates?
The risk of a negative reaction to anesthesia, as well as the risk of infection, accompany any surgery. In minimally-invasive surgeries like kyphoplasty, the surgeon will use specialized techniques to limit the size of incisions used—this decreases risks to the patient for infection and other complications, and can shorten pain and recovery times.
Overall complications associated with kyphoplasty are rare, estimated to occur in less than 4 percent of cases. These rare cases can include complications with the bone cement, including allergic reactions. Leakage of the bone cement can occur when the injected cement moves beyond the spinal compression cracks it was intended to repair, but this leakage itself rarely causes complications. Balloon kyphoplasty reduces the risk for bone cement leakage, as it is more likely to stay within the space of the balloon. Persistent or worsening pain is a rare, but possible risk if a nerve root or spinal cord becomes exposed to bone cement leakage. Paralysis is a risk with any spinal surgery, however this risk is extremely rare in kyphoplasty.
For some people, pain relief after surgery is almost immediate. Many others report the reduction or elimination of pain within two days. Kyphoplasty is not associated with any long-term limitations in mobility and, because of the pain relief and bone stability the procedure provides, many people find they are able to resume activities that had been limited by a spinal compression fracture. Studies have found that patients who choose kyphoplasty over medical management for spinal compression fractures report better long-term pain relief and better functionality.
Learn more about spine care expertise at Weiss, where we guide patients through each step of their spine care, from diagnosis to recovery.