Nonsurgical Pain Management of Spinal Fracture
Treatments for spinal fracture have traditionally been limited to pain management.
When the fractured vertebra is left to heal in its collapsed state, it can result in a curvature of the spine, called "kyphosis." Each additional spinal fracture increases the spinal deformity,3,4,5 and the spinal curvature can become more pronounced.
Nonsurgical treatments for management of spinal fracture pain typically include the following:
Extended Bedrest—Limiting movement can help reduce the pain of spinal fracture and prevent additional injury, but prolonged bed rest can also contribute further to bone loss, and increase your risk for subsequent fractures. 1
Pain Medication—Opiod analgesics are often prescribed to suppress pain, but they should be used with caution. Some of their side effects, like dizziness or weakness, may increase your risk of falling and causing further injury.
Physical Therapy—Physical therapy is used to strengthen the back muscles that help support your spine, and can play an important role in delaying or preventing another spinal fracture. Regimens often include weight-bearing activities and stretching exercises.
Back Braces—Back braces may help alleviate pain and allow you to begin physical therapy earlier to decrease the effects of spinal fracture on your posture, but long-term bracing may not be recommended by your doctor.
Alternatives to Nonsurgical Pain Management: Minimally Invasive Procedures
Unfortunately, these nonsurgical treatments may not address existing spinal deformity caused by the vertebral compression fracture.
Repairing the fractured vertebra early may help you avoid some of the chronic health problems caused by spinal fractures. If you’re at risk for spinal fracture, or have already had a spinal fracture, consider asking your doctor about these minimally invasive procedures at your next appointment:
Balloon Kyphoplasty—A procedure that uses surgical balloons to gently elevate the fractured vertebra in an attempt to return it to the correct position, and bone cement to repair and stabilize the vertebral compression fracture.
In a trial published in 2009 comparing nonsurgical treatments and balloon kyphoplasty, the balloon kyphoplasty patients were shown to have: 2
- More rapid improvement in quality of life
- More rapid improvement in back function and mobility
- More rapid improvement in back pain relief
Balloon kyphoplasty resulted in more rapid improvements above with all measures statistically significantly different at one month. The benefits of balloon kyphoplasty were sustained on average through 12 months.
Vertebroplasty—Also uses bone cement to help stabilize the vertebral compression fracture, but it doesn’t address the underlying spinal deformity.
Important Safety Information
The complication rate with KYPHON® Balloon Kyphoplasty has been demonstrated to be low. There are risks associated with the procedure (for example, cement leakage), including serious complications, and though rare, some of which may be fatal. This procedure is not for everyone. A prescription is required. Please consult your physician for a complete list of indications, contraindications, benefits, and risks. Only you and your physician can determine whether this procedure is right for you.
- Cooper C, Atkinson EJ, O'Fallon WM, Melton W III. Incidence of clinically diagnosed vertebral fractures: A population based study in Rochester, Minnesota, 1985-1989. J Bone Min Res. 1992;7:221-227.
- *† Wardlaw D, Cummings SR, Van Meirhaeghe J, et al. Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial. The Lancet. 2009; 373:1016-24
- Lindsay, R., S. Pack, and Z. Li, Longitudinal progression of fracture prevalence through a population of postmenopausal women with osteoporosis. Osteoporos Int, 2005. 16(3): p. 306-12.
- van Schoor NM, Smit JH, Twisk JW, Lips P. Impact of vertebral deformities, osteoarthritis, and other chronic diseases on quality of life: a population-based study. Osteoporos Int 2005;16(7)xf:749-56.
- Black, D.M., et al., Prevalent vertebral deformities predict hip fractures and new vertebral deformities but not wrist fractures. Study of Osteoporotic Fractures Research Group. J Bone Miner Res, 1999. 14(5): p. 821-8.
- Quantitative analysis of perioperative complication rates in balloon kyphoplasty and vertebroplasty (meta-analysis). Medtronic Spine LLC; 2006 December 11, 2006.