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Spinal Fractures, Vertebroplasty, and Kyphoplasty

During a sudden trauma like a car accident or slip-and-fall, the vertebra bone is susceptible to breakage just like any other bone in the body. Due to the shape of the vertebrae, they usually do not completely snap in half, but instead suffer major fracturing. When a vertebra fractures, a patient can experience severe side effects and pain. In order to repair this injury, surgeons have developed an innovated solution called vertebroplasty and kyphoplasty.

Spinal Fractures

Because the vertebrae are such integral bones to the body’s structure, and because of their proximity to the spinal cord and nerves, a spinal fracture can have serious consequences. This crushing of the vertebra bone can cause nerves to be pinched and damage to the spinal nerves or spinal cord—both of which can be extremely painful. Depending on how severe the injury is, a person suffering from a spinal fracture due to sudden trauma may experience back or neck pain, trouble walking, difficulty performing daily tasks, and even disfigurement. Some treatments are conservative in nature and only require mild actions, but some more severe injuries need surgery to be corrected. Luckily, there are viable, minimally invasive options for those patients.

Basic Anatomy of the Spine

The human spine is a series of in-line bones running the length of the back that support the framework of the entire body. In addition to structure, the spine also houses the spinal cord, which has millions of nerves that branch off of it as they head toward every part of the body.

The spine is made of a series of 33 bones called vertebrae. These are each divided by a cushioning substance known as a spinal disc. Within the vertebra, there is a protective hollow channel called the spinal canal which houses the spinal cord as it runs the length of the body. The spinal cord is an integral part of the human body, as it transmits information and is responsible for nearly every movement the body makes. For this reason, it is easy to see why damage to these bones (and as a result the spinal cord and nerves) is so precarious.

What is a spinal fracture?

When an excess of pressure is placed on a bone, it breaks; just like anything else in the physical world. This occurs during sudden force, through either an accident or some other violent event, shattering and collapsing the vertebra bone. This may also happen with relatively minor force if the bones are weakened by osteoporosis.

Spinal fractures are commonly called compression fractures, since the vertebra actually compresses and loses some of its height. In order to technically qualify as a compression fracture, the vertebral bone must decreased by at least 15 to 20% in height. However, any type of breakage in the vertebra is serious.

Compression fractures are also known as a vertebral fracture, an osteoporotic fracture, or a wedge fracture. The term wedge is used because the fracturing usually occurs either on the front or back of the bone. This leads to compression on just one side, resulting in a wedge-like shape. However, depending on the trauma, it is possible for the entire bone to fracture and reduce in height. This is called a crush fracture.

If the entire bone breaks and compresses, the result is an extremely unstable injury. These often require immediate surgery to repair. Wedge fractures may or may not be stable, with treatments varying by degree. It is also possible when there is a complete crushing of the vertebra for bone fragments to extend out into other areas. This is aptly named a burst fracture. This type of fracture involves some loss of the height in both the front and back walls of the vertebral body (rather than just the front of the vertebra). Making this distinction is important because burst fractures can be unstable and result in progressive deformity or neurologic compromise.

Spinal fractures can occur on any one of the vertebrae; however a majority of these injuries occur in the mid to lower back regions, usually between vetebraeT12-L1.

Spinal Fracture Symptoms and Causes

The symptoms of a spinal fracture vary greatly, depending on the severity of the injury. Sometimes, spinal fractures cause no pain or symptoms at all. Sometimes, they may cause severe paralysis and disability.

Some more common symptoms include:

  • Back or neck pain
  • Numbness
  • Tingling
  • Muscle spasm
  • Weakness
  • Bowel and/or bladder problems
  • Spinal deformity
  • Height loss

The two most common causes of a spinal fracture are weaken bones (osteoporosis) or sudden trauma. For this article’s purposes, we will focus on trauma-caused fractures.

To break down fracture causes from trauma:

45% from car accidents

20% from falls

15% from sports injuries

15% from violence

5% from other miscellaneous sources.

Diagnosing and Treating a Spinal Fracture

After a car accident or sudden trauma, it is important that doctors perform a series of tests and scans on their patient to determine if there are any major internal injuries that cannot be seen. If you are experiencing back or neck pain in the days or weeks after a car accident, you will want to see your doctor or healthcare professional to have the same tests done. Either way, in order to treat a painful spinal fracture, a doctor must first find the problem.

Like other back and bone injuries, there are three common diagnostic tests performed to see inside the body. They are:

  • X-ray
  • Computed Tomography (CT scan)
  • Magnetic Resonance Imaging (MRI)

Treatment for a spinal injury varies between stabilizing the injury and letting it heal on its own, repairing the injury with some type of fusion, or performing a surgery to inflate the bone.

  • Braces – Use of back or neck brace to maintain spinal alignment and immobilizes the spine while the bone heals on its own.
  • Fusion – Repairing of the vertebra with hardware such as plates, rods, screws, or cages. This basically acts in the same way screws would on wood (holding the pieces together) except with bone the pieces will eventually fuse together to form one strong bone again.
  • Minimally Invasive Surgery – Vertebroplasty & Kyphoplasty are procedures designed to repair bone fractures by pumping the damaged bone with a small amount of cement.

Vertebroplasty and Kyphoplasty

Vertebroplasty and kyphoplasty are very similar, minimally invasive surgeries that treat a spinal fracture by restoring the vertebra height. These procedures offer the obvious benefit of repairing the bone, but they can also be useful for preventing further damage, future fractures, and to relieve pain associated with the injury.

What is Vertebroplasty?

Vertebroplasty is a procedure in which a type of cement is injected directly into the fractured vertebra in order to repair the cracks and strengthen the structure.

Because the procedure only uses a needle to inject the patient, the recovery time is minimal, with most patients going home the same or next day. During the procedure, patients are given a local anesthetic to numb the injections area and light sedation to relax them.

Using fluoroscopic x-ray to help guide the needle, the performing surgeon injects a low viscosity bone cement into the fractured vertebra. The cement then quickly hardens within 5 minutes, forming a lasting and strong structure that supports the vertebra while providing stabilization and strength.

What is kyphoplasty?

Kyphoplasty is the same procedure as a vertebroplasty except a small, inflatable balloon is used to raise the vertebra and create a pocket before injecting the cement. This procedure is often chosen if the vertebra is significantly collapsed on one or both sides. Unlike vertebroplasty, surgeons performing kyphoplasty must first use a drill to create a channel through which they can insert the needle and balloon. The surgeon then gently inflates the balloon, raising the vertebra back to its normal height. This may be done on just one side of the vertebra or two, depending on the fracture’s severity. The balloon is then deflated and pulled back out, leaving behind an open cavity and a raised vertebra. The cavity is then injected with a special cement (as above) and allowed to dry.

Because kyphoplasty involves more materials and steps, the procedure tends to be a little more expensive. It also has a longer recovery time then vertebroplasty since the bone is actually drilled into.

Both procedures offer a quick healing time and nearly instantaneous results.

Dolman Law Group

The Dolman Law Group is a Florida personal injury law firm that specializes in spinal injuries. We are committed to helping those people who are injured by the negligence of others recover for their losses. To schedule a free consultation and case evaluation with one of our experienced attorneys, call our office today at 727-451-6900 or send us an email through our online contact form.