In the typical benign compression fracture, the vertebral body marrow signal has a relatively homogeneous decreased intensity and may exhibit patchy areas of more normal marrow, whereas pathologic compression fractures tend to be completely replaced by abnormal marrow. Richard Winn MD, in Youmans and Winn Neurological Surgery, 2017 Benign Versus Pathologic Compression Fracture.ĭistinguishing between benign and malignant compression fractures on imaging is often difficult ( eFig. Centers for Disease Control and Prevention. Vertebral augmentation (vertebroplasty and kyphoplasty) (adult). Physical Medicine and Rehabilitation Clinics of North America. Osteopathic thoracolumbar vertebral compression fractures: Clinical manifestations and treatment. In: Skeletal Trauma: Basic Science, Management, and Reconstruction. That's why it's important to also diagnose and treat the cause of the bone weakness. People who have one compression fracture have a higher risk of more fractures in the future. Newer studies show that vertebroplasty and kyphoplasty often relieve pain from compression fractures for at least a year.Ī compression fracture is a sign of weakened bones. However, both vertebroplasty and the shot that didn't provide treatment relieved pain. Some early studies showed that vertebroplasty worked no better than a shot that didn't provide a treatment, called a placebo. Study results have been mixed as to the effectiveness of vertebroplasty. You should avoid heavy lifting for at least six weeks. Protect your skin from the ice with a cloth. The place on your back where the needles were inserted might be sore for a few days. You'll need to arrange in advance for someone else to drive you. Most people who have vertebroplasty or kyphoplasty go home the same day. Radiation treatment of that bone's cancer also may happen before or after the procedure. If the fracture was caused by cancer, a small sample of bone tissue may be removed for testing. Special types of X-rays or CT scans are taken during the procedure, to guide the needle into the spinal bone. It may take longer if more than one spinal bone needs treatment. Vertebroplasty usually takes about an hour. You'll lie facedown and get numbing shots in your skin. Sedation drugs make you relaxed and sleepy. Most people, though, just need to be sedated. General anesthesia keeps you in a sleep-like state during the procedure. The type of anesthesia you receive depends on the type of procedure and the number of spinal bones involved. You'll likely have a flexible narrow tube inserted into a vein in your arm or hand. You should arrange in advance for someone to drive you home. Wear comfortable clothing and leave your jewelry at home. Follow your health care provider's instructions. You may need to avoid taking blood thinners for a few days before the procedure. If you take daily medications, you may be able to take them the morning of the procedure with small sips of water. You may need to avoid eating or drinking for several hours before vertebroplasty or kyphoplasty. These procedures might increase the risk of fractures in neighboring spinal bones. Very rarely, this can damage these organs and sometimes even cause death. Tiny pieces of this leaked cement also can enter the bloodstream and move to the lungs, heart, kidneys or brain. This can cause new symptoms if the cement presses on the spinal cord or nerves. Part of the cement can leak from the spinal bone. Risks associated with either procedure include: Then the balloon is deflated and removed before the cement is injected. The balloon is inflated to create more space inside the bone. In a similar treatment, called kyphoplasty, a balloon is first inserted into the spinal bone. Vertebroplasty involves injecting a type of bone cement into a broken spinal bone.
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