Vertebral compression fractures (VCF) are the most common complication of osteoporosis or low bone density, affecting more than 750,000 Americans annually.
What is vertebral augmentation?
Vertebral augmentation is an outpatient procedure, where the vertebral body or sacrum is stabilized with orthopedic cement through a simple needle access placed into the bone, through the back. The physician will create space in the bone before the cement is injected, making the procedure extremely safe.
If a needle or curette is used to create a cavity for the cement the procedure is simply termed “vertebral augmentation.”
If a balloon is used to create the space for the cement, the procedure is termed “kyphoplasty”.
Another treatment option is Spine Jack, a recently FDA approved device from Stryker. Depending on the site of the fracture, or if there is significant deformity of the fractured vertebrae, Spine Jack may be used to restore the original shape of the vertebral body prior to the injection of the cement.
Sacral augmentation is one treatment option for sacral insufficiency fractures (SIF). The fractured osteoporotic bone is injected with a medical cement through a small needle access. This procedure is performed on one or both sides of the sacrum.
Your physician should discuss which option for treatment is appropriate at the time of your consultation.
Patients who receive treatment for vertebral compression fracture will also be medically treated for their low bone density with bisphosphonate or anabolic bone medications as published literature shows that patients who are medically treated after a vertebral compression fracture have a 40-70% reduction in the incidence of new fractures.
Why would you need vertebral augmentation?
Statistically, 50% of women and 25% of men will experience an osteoporotic compression fracture in their lifetime. Patients with cancer and who take steroids for chronic medical diseases are also at high risk of compression fractures.
Vertebral compression fractures are most common in the weight bearing bones of the spine in the low thoracic and lumbar spine but can occur in any bone in the spine or in the sacrum. These fractures can result in significant loss of mobility and quality of life due to pain, which may be so severe as to require hospitalization for pain control.
Some patients improve with conservative therapy alone, but those who are significantly debilitated by their fracture and have persistent pain despite conservative treatment, often benefit from vertebral augmentation with substantial improvement in pain and mobility immediately after the procedure.
The procedure is very safe. Major complications of infection or nerve injury from the procedure occur in < 0.5% of cases. Patients who are good candidates for the procedure can expect reduction in their pain immediately after the procedure. Patients typically achieve at least 50% pain reduction at the time of procedure. You doctor will then prescribe physical therapy as well as bone strengthening medications to continue pain reduction in the ensuing weeks and months.
Conditions to let us know about
Let your doctor know if you have pain that radiates down your legs as this may indicate pinched nerves.
Vertebral augmentation is covered by most private insurance providers as well as Medicare.
Preparing for your procedure
Vertebral augmentation can be performed under conscious sedation, or general anesthesia, depending on your overall health. If you are on blood thinners your doctor will instruct you when to stop these medications prior to the procedure.
Recovering from your procedure
Patients should increase their activity after the procedure, but avoid strenuous lifting. The vertebral bones treated during the procedure are stable immediately after, but the untreated bones remain osteoporotic and prone to fracture. This likelihood to future fracture decreases with medical treatment of osteoporosis.