Like other bones in the human body, the bones of the spinal column can be fractured. While anyone can sustain a spinal fracture because of trauma, such as a car accident, some people who have weakened or brittle bones can get a spinal fracture without any extreme forces being applied to their spine.
A specific type of spinal fracture, known as a compression fracture, occurs when a vertebral bone is compressed in a similar fashion to crushing a soda can. The degree of compression can range from mild to severe. While some compression fractures only affect the vertebral body, sometimes, cases bony fragments may be forced backward into the spinal canal and can affect the nearby spinal cord or spinal nerve roots. In addition to pain in the spinal region directly from the fracture, a person may have numbness, tingling, weakness, loss of bowel or bladder control, or paralysis if the nearby spinal cord or nerves are affected.
How to treat the pain
Some people with compression fractures don’t have any pain or other symptoms. However, people with new compression fractures usually feel some degree of pain. As mentioned above, pain related to a compression fracture is typically located in the spinal region immediately surrounding the fracture. This pain can be quite severe and limit a person’s activities. In these cases, interventional pain procedures may be a good option to improve pain and restore function.
Procedures known as kyphoplasties and vertebroplasties can be used to treat the pain related to spinal compression fractures and possibly to restore the height of the compressed vertebra. These procedures are typically performed in an operating room or other procedure area that is properly equipped. Patients are usually very comfortable during the procedure, thanks to medications used for pain relief and sedation given through an IV. The patient is positioned face-down on the procedure table and a surgical cleaning solution is applied to their skin. Surgical drapes are placed to isolate the target area as well. The spine is visualized using an x-ray machine and a very small incision is then made in the proper location after numbing the area with local anesthetic. A needle, known as a trocar, is then inserted through the incision and into the vertebral body. X-ray images are taken throughout the procedure to ensure that the needle is following the desired path without damaging any vital structures.
During a kyphoplasty, a balloon is then inflated to help restore the height of the compressed bone and to make space for surgical cement to be injected. During a vertebroplasty, cement is injected without inflating a balloon first. This cement acts as a “cast” and stabilizes the fractured bone. Once the cement hardens, which can sometimes take less than an hour, the pain is usually significantly reduced or completely resolved. The patient is monitored for a short period of time following the procedure and discharged that day.
Before undergoing a kyphoplasty or vertebroplasty, the patient needs to be evaluated by a healthcare professional trained in the diagnosis and treatment of spinal compression fractures. This process will also include reviewing medical history, getting imaging of the spine and a physical examination in order to ensure that there are no contraindications to the procedure. Make sure to discuss any potential risks of the procedure with your healthcare provider as well.
Learn more about pain management options at Ochsner.