Spinal Compression Fractures Treatment
Spinal Compression Fractures Treatment
To prevent future fractures, if osteoporosis has caused a spinal compression fracture, treatment should address the pain, the fracture, and the underlying osteoporosis.
According to Michael Schaufele, MD, a physiatrist and professor of orthopaedics at Emory University School of Medicine in Atlanta, “every component of treatment has greatly improved in the last decade.” “We have better interventional options to treat fractures and better treatments to prevent future fractures,” he tells WebMD.
The majority of fractures heal with pain medication, reduction in activity, medications to stabilize bone density, and a good back brace to minimize motion during the healing process. Most people return to their everyday activities. Some may need further treatment, such as surgery.
Spinal Compression Fractures: Nonsurgical Treatment
When a spinal compression fracture is allowed to heal naturally, the pain can last up to three months. However, the pain usually subsides in a matter of days or weeks.
Analgesic pain medications, bed rest, back bracing, and physical activity may all be used to manage pain.
Pain medications. A carefully prescribed “cocktail” of pain medications can relieve bone-on-bone, muscle, and nerve pain, explains F. Todd Wetzel, MD, professor of orthopaedics and neurosurgery at Temple University School of Medicine in Philadelphia. “If it’s prescribed correctly, you can reduce doses of the individual drugs in the cocktail.”
Over-the-counter pain medications are often sufficient in relieving pain. Two types of non-prescription medications — acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) — are recommended. Narcotic pain medications and muscle relaxants are often prescribed for short periods of time, since there is risk of addiction. Antidepressants can also help relieve nerve-related pain.
Bed rest may help with acute pain, but it can also lead to further bone loss and worsening osteoporosis, which raises your risk for future compression fractures. Doctors may recommend a short period of bed rest for no more than a few days. However, prolonged inactivity should be avoided.
A back brace provides external support to limit the motion of fractured vertebrae — much like applying a cast on a broken wrist. The rigid style of a back brace limits spine-related motion significantly, which may help reduce pain. Newer elastic braces and corsets are more comfortable to wear but don’t work, says Wetzel. “There’s an old saying, ‘The inconvenience of the brace is directly proportional to its effectiveness,'” he tells WebMD. However, braces should be used cautiously and only under a doctor’s supervision. Weakening and loss of muscle can occur with excessive use of braces for lumbar conditions.
Bone-strengthening drugs such as bisphosphonates (such as Actonel, Boniva, and Fosamax) help stabilize or restore bone loss. This is a critical part of treatment to help prevent further compression fractures.
Fusion of the Spine
Spinal fusion surgery is sometimes used to eliminate motion between two vertebrae and relieve pain in spinal compression fractures. The procedure joins two or more vertebrae, holds them in place, and prevents them from moving until they have a chance to grow together, or fuse.
Metal screws are inserted into the vertebrae via a small bone tube. The screws are attached to metal plates or metal rods that are bolted together in the spine. The vertebrae are held in place by the hardware. This prevents movement and allows the vertebrae to fuse. The spaces between the vertebrae are grafted with bone.
The patient’s own bone or bone from a bone bank can be used to create a graft. The patient’s own bone marrow or blood platelets — or a bio-engineered molecule — can be used to stimulate growth of bone for the procedure.