Treatment of vertebral compression fracture

Vertebral compression fractures (VCF) occur with an incidence of 700,000 annually. While most cases are caused by osteoporosis, tumors of the vertebral column can also cause these fractures. Patients with VCF suffer from severe pain, decreased mobility, a five fold increased risk of subsequent fractures and at times physical deformity and diminished pulmonary function.

Several minimally invasive methods are now available for the treatment of VCF and can be done on either an outpatient basis or with a brief hospital stay. All of these procedures are available through VNI physicians. While using different techniques to stabilize the fractured vertebrae, all of these procedures start with a small, specialized tube, called a trocar, inserted through a small skin “nick” and precisely guided to the bone. In the Vertebroplasty procedure, a needle is inserted through a tiny incision in the skin and carefully driven through the vertebrae while under real-time x-ray guidance. Cement is then injected into the broken vertebrae. With Kyphoplasty, 2 special balloons, called balloon tamps, are inserted into the broken bone. The balloons are then inflated, restoring the vertebral body to its natural height and creating a cavity. The balloons are then deflated and the resultant cavity is filled with cement, through the same needle used to introduce the balloon tamps. Both of these procedures essentially cast the broken vertebrae from the inside. Vertebral Body Augmentation involves the insertion of a weaved Dacron Mesh™ into the vertebral body which is filled with bony granules that expand the compressed vertebral fracture in an attempt to increase vertebral body height and correct the bony deformity. All of these procedures are performed in a minimally invasive fashion, utilizing image guidance, through tiny skin incisions.

Before patients are scheduled for a VCF procedure, our physicians first attempt a trial of conservative therapy with pain reducing medications and specially designed back braces. At the same time, a thorough investigation is initiated to determine the cause of the vertebral fracture. Patients receive x-rays, an MRI, CT scan or bone scan. In addition, blood tests are drawn to evaluate for certain conditions that can predispose to “thinning of the bones,” a condition referred to as osteoporosis. Using these results, we can work with the patient’s primary care physician to initiate therapy that will prevent future fractures by strengthening bone.