More than 40 million people in the United States have osteoporosis (a decrease in the amount of bone mass) or have thinning of the bones that puts them at risk for spine fractures (broken bones). Thinning of the bones can occur at any age, but it is most common in older adults. If weakened bone in the spine collapses, this is called a "compression" fracture. This usually causes severe back pain. When several of the bones collapse, loss of height or stooped posture (sometimes called "widow's hump") may occur. Usually, the fracture gets better by itself, and the pain finally goes away. But some patients have ongoing pain because the collapsed bone continues to move and break.
Most fractures of the spine are treated with bed rest until the pain goes away. Pain medicines, back braces and physical therapy may also be used. For some patients, doctors may prescribe a medicine called calcitonin. It appears to help make the bone stronger. Sometimes, patients may need surgery to secure the spine using a bone graft or an internal metal device. A treatment called vertebroplasty may help hold the fractured bone in place and relieve pain.
Percutaneous vertebroplasty is a procedure that involves placing a small needle into the crushed bone. The doctor guides the needle into position using special X-ray equipment, so open surgery isn’t necessary. Once the needle is in position, a bone cement is injected into the bone to secure it. Several crushed bones can be treated at the same time. The procedure generally takes about one hour for each bone that is treated. It is usually done using only numbing medicine (local anesthetic). Some patients who are in severe pain may need extra medicine to make them sleepy. Usually, patients can leave the hospital a few hours after the procedure is done.
Many patients feel pain relief right away after vertebroplasty. Most report that their pain is gone or is much better within 48 hours. Most patients resume normal activity within 24 hours.
Vertebroplasty is safe. The bone cement used to secure the broken bone is safe. Patients with tumors on the spine may be at slightly higher risk of complications. You should always discuss the risks of any procedure with your doctor.
If you have significant back pain caused by a broken bone in your back, and the pain is not better after 1 to 2 weeks of bed rest and pain control medicine, talk to your doctor about whether vertebroplasty is right for you. Newer fractures tend to respond better than older fractures; however, some older fractures can be treated successfully. The procedure does not help with chronic back pain or herniated discs.
Percutaneous Vertebroplasty: New Treatment for Vertebral Compression Fractures by TA Predey, MD; LE Sewall, MD; SJ Smith, MD (American Family Physician August 15, 2002, http://www.aafp.org/afp/20020815/611.html)
Written by familydoctor.org editorial staff