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Back Pain (Vertebral Fractures)

Back pain is one of the most common complaints from patients in the United States. At some point, nearly everyone will have back pain. Often, the pain can be corrected through conservative measures such as rest, heat, medication or therapy. But, if the pain is caused by compression fractures due to osteoporosis surgical intervention may be a good option.

Osteoporosis weakens bones and causes them to become brittle and break. This often happens in different locations throughout the body, most often in the hip, wrist and spine. When fractures occur in the spine, patients can have extreme and constant pain, deformity and even nerve compression.

WakeMed Raleigh Campus offers two therapeutic and preventative procedures for compression fractures. Performed by specialty trained interventional radiologists, vertebroplasty and kyphoplasty provide immediate relief from pain and can help patients return to a more active lifestyle.

Prior to having either procedure and to determine which intervention is best, patients undergo an MRI to assess the acuity of the compression fracture. For patients who cannot undergo an MRI, a bone scan and CT scan can be used in combination. Optimal results are obtained in patients with active bone edema (swelling), usually within two to six weeks of the fracture. The procedure is primarily performed to repair fractures in the middle to lower spine and in the sacral region. Typically, the procedure is not done in the upper spine because of the smaller size of the vertebrae.

Vertebroplasty and Kyphoplasty

Vertebroplasty is performed using conscious sedation and a local anesthesia. Under fluoroscopic guidance, the interventional radiologist inserts a needle/cannula into the fractured vertebral body and infuses it with surgical bone cement. The cement hardens within 15 minutes, stabilizing the fracture and preventing further collapse. In most cases, the procedure is completed in less than one hour.

Like vertebroplasty, kyphoplasty is performed on an outpatient basis. With kyphoplasty, a balloon is introduced into the center of the vertebral body through a catheter to create a cavity in the bone and to increase the height of the fractured vertebra. The balloon is removed and replaced with bone cement, which in injected into the site. This procedure stabilizes the vertebrae and usually brings immediate pain relief to the patient.

The overwhelming majority of patients report no pain from either procedure. If necessary, more than one vertebral level can be performed in a single procedure. Post-procedural fluoroscopic images are obtained for documentation. Afterwards, patients remain in bed for two hours. Most patients will have immediate pain relief or significant improvement over the next 48 hours. After either outpatient procedure, patients quickly return to their normal daily activities.

Learn What to Expect from Vertebroplasty and Kyphoplasty