Osteoporotic compression fractures

Patients often suffer compression fractures of the thoracic and lumbar spine secondary to osteoporosis.  These can occur with a minor trauma such as a slip and fall or simply bending or twisting the wrong way.  These fractures rarely require true surgical intervention as long as spinal alignment is well-maintained, there are no neurologic deficits, and pain can be well controlled.  Treatment often includes mobilization with physical therapy and pain control with oral medications.  A brace such as a lumbar sacral orthosis (LSO) or a thoracolumbar sacral orthosis (TLSO) may be prescribed by your physician.  Another option is treatment with vertebral body augmentation using cement.

compression fractureTwo procedures exist:  these are referred to as kyphoplasty and vertebroplasty.  Both procedures involve injecting cement via a catheter into the fractured vertebral body to stabilize the fracture and reduce pain, and both have essentially been shown to be equally effective.  A kyphoplasty involves the inflation of a balloon and the injection of cement under low-pressure.  A verterbroplasty involves inject cement without a balloon, allowing the cement to fill the abnormal voids in the bone secondary to the fracture. These are typically done under local anesthesia in the outpatient setting

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