March 4, 2021 by Peter B. Laird
Outpatient Procedure Can Instantly Relieve Chronic Back Pain from Compression Fracture
Each year in the United States, roughly 1.5 million people are diagnosed with compression fractures of the spine, a painful condition that can severely limit one’s mobility and quality of life. These fractures also explain why abuelita seems to be shrinking as she ages, explains a neurosurgeon with Baptist Health South Florida.
“Each of the spine’s vertebrae is more or less cylindrical, stacked one on top of the other,” says Justin Sporrer, M.D., a neurosurgeon at Miami Neuroscience Institute who specializes in general neurosurgery, functional neurosurgery and deep brain stimulation for movement disorders. “Now imagine pushing straight down with some force on an empty soda can – it maintains its cylindrical shape but it crunches down and loses height. That’s what happens with your vertebrae with a compression fracture.” He notes that, over time, you can actually lose two to three millimeters of spine in each of your vertebrae, which is why your grandmother really has gotten shorter as she gets older.
What causes compression fractures?
Compression fractures result from a variety of causes, according to Dr. Sporrer, including falling, lifting heavy objects, sitting down hard on a chair, or other routine activities. Sports, especially downhill skiing, where the spine absorbs a lot of impact and wipeouts aren’t uncommon, can be to blame, too.
One of the primary causes of compression fractures, says Dr. Sporrer, is something far less obvious – osteoporosis (porous bone), a bone disease that occurs when the body loses too much bone, makes too little bone, or both. For people with osteoporosis, their bones become weak and may break from a fall or, in serious cases, from something as innocuous as a sneeze or a minor bump. Even lifting a light object can cause a compression fracture, he adds.
Why are older women at risk for compression fractures?
“Osteoporosis is the number one risk factor for compression fractures,” Dr. Sporrer says. “Our bodies are building bone even into our twenties but as we age, we start losing our bone density.” That’s why older people – especially women – are particularly at risk, he adds. “Roughly a quarter of all post-menopausal women will suffer a compression fracture in their lifetime.”
A common misconception is that we can increase our bone density simply by taking daily calcium supplements. “Unfortunately, it’s not that easy,” says Dr. Sporrer. “If your body’s bone-building mechanisms are compromised, a calcium supplement isn’t going to help you. Your vertebrae will continue to compress, and the nerve endings around the outside of the bone – or periosteum – become very sensitive to any kind of stretching. That’s where the pain comes from with compression fractures.”
How can someone tell if they have a compression fracture?
Dr. Sporrer says such fractures are almost always accompanied by a sudden onset of acute back pain, often as the result of a fall. “The hallmark is if the pain goes away while you’re laying still in bed. If the pain returns as soon as you move, it’s most likely not muscle pain but instead a compression fracture,” he notes. “Muscle strains will hurt even if you’re lying in bed.”
Dr. Sporrer advises post-menopausal women to get a bone density scan, which will determine if there is any osteoporosis. “And if you have acute onset of back pain after a fall, get it checked out as soon as possible,” he says. “Compression fractures left untreated never get better with time – they only become more painful, and place increasing limits on your mobility and your quality of life.”
Can compression fractures be repaired?
The answer is yes, according to Dr. Sporrer, who employs a surgical technique known as kyphoplasty to repair compression fractures, relieve pain and improve mobility when other measures fail to provide relief.
“With kyphoplasty, we’re trying to do two things: restore the height of the bone, and then strengthen the bone by cementing it in place and filling in any empty spaces or fracture lines,” he says, adding that the procedure is more likely to be successful if done within two months of a fracture diagnosis.
How does kyphoplasty work?
Kyphoplasty is a minimally invasive, outpatient procedure, performed using local anesthesia and mild sedation, uses two different x-ray machines to locate the exact site of the fracture and to guide the surgeon who, using a needle, inserts a tiny, deflated balloon into the fractured vertebrae.
“Once inserted, we inflate the balloon, which restores height to the vertebrae and also pushes any loose bone out towards the edges,” Dr. Sporrer says. “Then we deflate and withdraw the balloon and inject a fast-setting, medical grade plastic cement into the bone a few drops at a time.” The cement quickly hardens in the presence of body heat, he says, and, once it sets after a few minutes, it can withstand pressure of as much as 400 pounds per square inch.
What is recovery like following kyphoplasty?
The procedure takes about 15 minutes, according to Dr. Sporrer, who has used it to successfully treat more than 500 patients with compression fractures ranging from mild to severe. “With kyphoplasty, there is no hospital stay, no physical therapy, no recovery time, no stitches, and you’re back on your feet the very next day,” he says. And, he adds, there’s an excellent chance you’ll be able to live pain-free following the procedure. “Here at Miami Neuroscience Institute, we typically see significant pain relief in roughly 80 percent of our patients.”