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What to do about vertebral fractures?

What to do about vertebral fractures?

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An x-ray of the spine can confirm the diagnosis. Vertebral compression fractures in postmenopausal women are usually caused by osteoporosis, but occasionally they result from trauma, infection, or a cancerous tumor.
Treatment for painful fractures starts with over-the-counter analgesics. Severe pain may require short term bed rest and stronger drugs. Prolonged bed rest should be avoided, as it can contribute to bone loss and other health problems. Ice or heat packs applied to the affected area of the spine may also help. A back brace is usually recommended to help manage pain and stabilize the spine as it heals.

Procedures for Treating Vertebral Fractures:
Two minimally invasive procedures vertebroplasty and kyphoplasty involve the injection of a medical cement to stabilize compress vertebrac. Introduced in the United Sates in the 1990s, they’ve become increasingly available for the treatment of fracture pain that doesn’t respond to more conservative therapy.
Before either procedure, MRI is usually performed to determine if the patient is likely to benefit. A good candidate is one whose MRI shows the presence of bone edema, or fluid, which is associated with recent fracture. If bone edema is absent, that implies the fracturehas healed and is not what’s causing the pain. An MRI can also help ascertain whether a disk, the spinal cord, or other soft tissue is involved.
Both Kyphoplasty and vertebroplasty are performed percutaneously (that is through the skin), often as day surgery and under conscious sedation. If the fractures are numerous or severe, or the patient is older and in poor health or cannot tolerate lying on his or her stomach – general anesthesia may be used. Sometimes an overnight hospital stay is necessary.

Vertebroplasty: Guided by Computed tomography (CT) of fluoroscopy (real-time x-rays), a specially trained neurosurgeon or orthopedic surgeon inserts a hollow needle through a small incision in the skin into the compressed portion of the vertebra. When the needle is in place, she or he injects surgical cement (methyl methacrylate), which has the consistency of toothpaste. It’s mixed with an agent that allows the physician to see its flow into the vertebra. The cement hardens within about 15 minutes. The Patient is monitored for two to three hours in the recovery room before going home.

Kyphoplasty:-In the procedure, which is also image- guided and performed through tiny incisions in the back, inflatable balloons are inserted through tubes in both sides of the fractured vertebra . The balloons are inflated, creating a cavity and restoring vertebral height. They are then deflated and withdrawn and the cavity is filled with cement. The procedure takes 30 to 60 minutes for each fracture and sometimes involves an overnight hospital stay.

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