Kyphoplasty: This is a newer procedure that involves placing a catheter with a balloon into a collapsed vertebral body and slowly inflating the balloon to help the fracture and restore height. Special surgical cement is injected into the cavity created by the balloon once it has been deflated. The goal is to keep the fracture from getting worse, and to restore vertebral body height. There is a lesser risk of leakage of the surgical cement when compared to vertebroplasty.
Vertebroplasty: This procedure is similar to kyphoplasty, but no balloon is used. A cement mixture of polymethylmethacrylate is injected into the vertebral body to lend support and stabilize the fractured spine. The goal is to reduce or eliminate fracture pain, but this procedure does not address spinal deformity.
Major anterior/posterior reconstruction/fusion: This is a major procedure with higher risks in the elderly patient. It is difficult to do surgery on weak bones that are fragile.
Nonsurgical treatment for Spinal Compression Fractures
Pain medications. A carefully prescribed "cocktail" of pain medications can relieve bone-on-bone, muscle, and nerve pain.
Over-the-counter pain medications are often sufficient in relieving pain. Two types of non-prescription medications acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) are recommended. Narcotic pain medications and muscle relaxants are often prescribed for short periods of time, since there is risk of addiction. Antidepressants can also help relieve nerve-related pain.
Activity modification. Bed rest may help with acute pain, but it can also lead to further bone loss and worsening osteoporosis, which raises your risk for future compression fractures. Doctors may recommend a short period of bed rest for no more than a few days. However, prolonged inactivity should be avoided.
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Sleep on your back with a pillow under your knees. This will decrease pressure on your back. You may also sleep on your side with 1 or both of your knees bent and a pillow between them. It may also be helpful to sleep on your stomach with a pillow under you at waist level.
One of the most important aspects of healing from a compression fracture is preventing re-injury. If you have surgery, you should always follow any instructions given by your surgeon and avoid any lifting or exercise for at least several weeks.
With surgery for a compression fracture, you will not be able to twist or bend your back for as much as 6 weeks following the surgery. That means that you will have to change the way that you do a lot of your normal activities of daily life, such as getting out of bed. Your surgeon may prescribe physical therapy to help you learn the correct and safe way to move throughout your day, so be sure to keep all of your physical therapy appointments and perform the recommended activities and exercises they ask you to do as well.
Anytime you move, remember that the goal is to keep the spine as straight and lengthened as possible, to avoid placing unnecessary strain on the back. It’s important that you always sit up as tall as you can so you don’t put additional pressure on the spine and that you do NOT bend over to get out of bed.
Instead, you should always follow your provider’s recommendations and use the following tips for getting out of bed with a compression fracture:
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For the most part, nonoperative treatments are recommended for compression fracture. These treatments include pain medications and modified physical activity. The doctor may recommend wearing a brace that helps support the back and prevents bending forward, and therefore removes pressure from the fractured vertebrae.
There's a good chance you won't need surgery. Most people can get by without it. Compression fractures usually heal on their own in about 3 months. While that happens, your doctor may suggest you try some things at home that can make you feel better, such as pain medicines, rest, physical therapy, or a back brace.
You can often get relief with an over-the counter drug like ibuprofen or acetaminophen. Check with your doctor to see which one is right for you. Your doctor might prescribe a stronger medicine for more intense or persistent pain.
The doctor might also suggest you take the hormone calcitonin. Studies show it can help ease the pain from compression fractures.
You don't want to overdo it with activity, but you also don't want to stop moving entirely. Lying around for too long can weaken your bones even more. Your doctor might recommend bed rest for a short period of time. After several days or as soon as you start to feel better, gradually ease back into your old routine.
For a few weeks or months you may still need to avoid heavy exercise that could make your injury worse. Ask your doctor when it's safe for you to get active again and what the best ways to get moving are.
Once you're feeling better, ask your doctor if you should join a rehab program or work with a physical therapist. Exercises that strengthen your back can help you avoid having more compression fractures.
Check with your doctor about the best weight-bearing exercises for you, such as:
They're all good for strengthening bones. Or try tai chi, which improves balance and helps prevent the falls that lead to fractures.
Wearing a back brace when you have a spinal compression fracture is similar to wearing a cast when you have a broken arm. It's made of a rigid frame that takes pressure off the painful bone and limits your movement. It gives your injured vertebrae the small bones that make up your spinal column time to heal.
There isn't much research to prove that a brace helps heal compression fractures, but one study shows it can ease pain.
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Vertebral compression fractures (VCFs) occur when the bony block or vertebral body in the spine collapses, which can lead to severe pain, deformity and loss of height. These fractures more commonly occur in the thoracic spine (the middle portion of the spine), especially in the lower part. Spinal compression fractures are the most common type of osteoporotic fractures. These vertebral fractures can permanently alter the shape and strength of the spine. The fractures usually heal on their own and the pain goes away. However, sometimes the pain can persist if the crushed bone fails to heal adequately.
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nonoperative treatments are recommended for compression fracture. These treatments include pain medications and modified physical activity. Most compression fractures due to injury heal in 8 to 10 weeks with rest, wearing of a brace, and pain medicines. However, recovery can take much longer if surgery was done.
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Spinal fractures are different than a broken arm or leg. Depending on how severe your injury is, you may experience pain, difficulty walking, or be unable to move your arms or legs (paralysis). Many fractures heal with conservative treatment; however severe fractures may require surgery to realign the bones. Low impact activities, such as walking or tai chi, are good for your heart, and a healthy circulatory system can increase blood flow to the fracture and help your bones heal faster. It's also essential to avoid bed rest to minimize your chances of developing blood clots or deep vein thrombosis in your legs.
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