Compression and Wedge Fractures: Treatment and Recovery

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Vertebral Compression Fracture Treatment

The majority of mild to moderate compression fractures are treated with immobilization in a brace or corset for a period of six to twelve weeks. The duration of treatment is based on symptoms and x-rays. As pain subsides and x-rays show no change in the position of the spine and healing of the fracture, the brace may be discontinued.

The purpose of the brace is two-fold. Bracing helps to reduce acute pain by immobilizing the fracture. It also helps to reduce the eventual loss in height and in angulation from the fracture. Compression fractures treated in a brace tend to have less deformity than those treated without a brace. Occasionally, bracing beyond twelve weeks is indicated in those patients with severe osteoporosis.
Woman being fitted for a cervical collarCervical spine compression fractures may be immobilized using a rigid collar and/or a soft collar. Photo Source: Compression Fractures
Cervical spine compression fractures may be immobilized using a rigid collar and/or a soft collar. Medications, such as analgesics and/or muscle relaxants may help lessen the pain of a compression fracture.

Minimally Invasive Spine Surgery (MISS) and Vertebral Compression Fracture Care

Balloon kyphoplasty is a minimally invasive treatment performed to stabilize vertebral compression fractures and reduce pain. The procedure is performed under local or general anesthesia. After a small pathway is created into the fractured bone, a small orthopaedic balloon is guided into the vertebra. The balloon is gently inflated to create a cavity within the vertebral body. The cavity is filled with medical cement that sets to stabilize the fracture and reduce pain..

Percutaneous vertebroplasty is a surgical procedure performed under anesthesia that may be used to treat compression fractures. During this procedure, a catheter is advanced into the compressed vertebra. Through the catheter, bone cement is injected into the fractured vertebra. The bone cement hardens to stabilize the vertebral body. This procedure may be indicated in cases of severe osteoporosis, severe pain, or when a vertebral fracture fails to heal following bracing treatment.

When Surgery is More Extensive or Complex

More extensive spinal surgery is rarely indicated for patients with compression fracture. While some more extensive or complex spinal surgical procedure may be performed minimally invasively, sometimes an open approach is needed (eg, long incision). Indications would include severe fracture with neurologic injury, severe angulation, failure to heal with initial bracing, increased angulation despite bracing or late increasing neuologic deficit.

Spinal stabilization and fusion procedures may be necessary to stabilize the portion of the spine affected by the spinal fracture. Spinal instrumentation and fusion uses devices—such as rods, plates, interbody devices (eg, cage) and/or screws to stabilize the spine. Fusion employs the use of bone graft to join the instrumentation (devices) and bone as it heals together. The operative procedure may be performed from the front (anterior) or back (posterior) of the spine. These types of approaches involve the fractured vertebra and adjacent segments (vertebrae above and below the fracture). The type and extent of the surgery depends on the severity of the vertebral fracture, as well as the patient's general health, which is explained by the spine surgeon.

Recovery Includes Fracture Prevention

Most patients can expect to make a full recovery from their compression fracture. Typically, braces are worn for six to twelve weeks followed by three to six weeks of physical therapy (PT) and exercise. Some patients may benefit by use of a bone growth stimulator. PT and regular exercise can help a patient to regain core body strength and build endurance of the trunk musculature. Overall strength, aerobic capacity and flexibility are also helped by physical therapy.

Most patients can return to a normal exercise program six months after a vertebral compression fracture. Regular exercise, including anti-gravity movements is recommended to help increase bone density and prevent future compression fractures. A balanced healthy diet, and bone building supplements, and prescription medications recommended can help increase bone mineral density needed for strong bones.

Updated on: 03/26/19
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Kyphoplasty, Vertebroplasty, Vertebral Augmentation Implant: Treatments for Spinal Compression Fractures
Iain Kalfas, MD
Center for Spine Health
Cleveland Clinic
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Kyphoplasty, Vertebroplasty, Vertebral Augmentation Implant: Treatments for Spinal Compression Fractures

Vertebroplasty, balloon kyphoplasty and vertebral body augmentation are minimally invasive surgical procedures performed to stabilize the fracture and relieve back pain caused by with vertebral compression fractures.
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