Health Care

Does Osteoporosis or a Compression Fracture Mean You’ll Need Back Surgery?

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Compression fractures of the vertebrae – the bones of the spine – are very common. They involve a collapsing of one or more vertebrae, most commonly in the middle portion of the spine. Most compression fractures are fragility fractures caused from low impact events such as a ground-level fall or even stepping out of the shower. They happen because a person’s bones are too weak, a condition known as osteoporosis.

“In fact, if you get a low energy fracture, you have osteoporosis, no matter what your bone density scan says,” says Charles Nalley, MD, orthopedic surgeon at the AdventHealth Tampa Spine Center.

By the time they are 80, about 40 percent of women will experience at least one compression fracture. While osteoporosis is very common among postmenopausal women – estrogen helps maintain bone strength – it’s a condition that can affect older men as well.

Time Heals Most Compression Fractures

Even though these spinal compression fractures can be painful, the good news is that about 4 out of 5 will heal on their own, without the need for surgery. In these cases, the person will be pain-free once their fracture heals in about three months.

“Time will heal the injury,” Dr. Nalley says, “but the deformity will always be there.” If enough vertebral compression fractures occur, a person may develop a hunchback or dowager’s hump. To prevent future fractures, it’s important to treat one’s osteoporosis and make diet and lifestyle changes that will lead to stronger bones.

For 1 in 5 patients with a compression fracture, their pain does not go away with time. In those cases, they should see a spine surgeon who specializes in treating the spine to discuss their options.

Back Braces to Help with Compression Fracture Pain

Dr. Nalley advises most patients who come to him with compression fracture pain to first try using a back brace.

“A brace does not speed healing time, but it helps with pain,” he says. Dr. Nalley explains that the stability and support a brace provides can help the vertebrae heal more properly and thus prevent injury-related chronic pain.

Using a brace should be done under a doctor’s supervision, so see an orthopedic spine specialist if you have back pain that interferes with your quality of life. The types of braces used to treat compression fractures are rigid (hard) rather than flexible. These braces hyperextend the spine so that pressure is taken off the broken vertebra, allowing it to heal.

Surgery in Tampa to Treat Osteoporotic Compression Fractures

In the rare case of a severe, acute compression fracture, surgery to stabilize the spine may be the ideal treatment. The collapsing of the vertebra may have caused parts of the bone to put pressure on the spinal cord. To successfully treat the pain, the surgeon needs to know if it is caused by spinal stenosis or because one or more vertebrae is collapsed. Imaging tests such as an MRI – which can show active bruising inside the bone – provide the surgeon with the information required to make the right diagnosis. Sometimes these images suggest that a patient will improve with bracing and more time.

In the past, most spinal fractures were stabilized with metal pins and needles, and some patients may still need this internal fixation approach. However, for most compression fractures today, Dr. Nalley uses a procedure called a vertebroplasty. Commonly called kyphoplasty, this procedure stabilizes the spine. The orthopedic surgeon pushes surgical cement through a long needle and into the crushed vertebra. This cement bolsters the fractured bone, making it strong again.

Even though kyphoplasty or vertebroplasty is safer than traditional spine surgery, it still requires the patient to be under anesthesia. However, the procedure only takes about 10 minutes, so the patient spends more time being prepared for the operating room than actually being there.

“From the minute they wake up from the operation, patients find they have excellent pain relief,” Dr. Nalley says.

If you are in pain after a compression fracture and want to know if a back brace or kyphoplasty can help, see an orthopedic spine specialist at AdventHealth Tampa. Schedule an appointment by calling the Nurse Navigator at Call1-800-899-9608.

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