In some cases, spinal fractures can occur in younger patients with poor bone quality due to simple traumas. Although rare, fractures can also be seen in the postpartum breastfeeding period due to weakened bone quality. Patients with severe back and lower back pain should be evaluated from this perspective.
What Are the Symptoms of Osteoporotic Spinal Fractures? Is There a Risk of Early Paralysis in These Patients?
The first and most prominent complaint in these patients is usually back or lower back pain. Compared to high-energy traumas, the risk of paralysis at the moment of fracture is very low in these patients. However, if not treated, spinal cord compression can increase over time, leading to slowly developing neurological deficits.
How Is an Osteoporotic Spinal Fracture Diagnosed?
Imaging methods must be used in patients suspected of having an osteoporotic spinal fracture. The most valuable and definitive diagnostic method among these is MRI imaging. Sometimes, fractures may not be visible on CT and direct radiographs. With MR imaging taken with special sequences, the diagnosis of the fracture can be easily confirmed. For this reason, examining elderly osteoporotic patients with MRI is essential to avoid missing a diagnosis. For patients who cannot undergo MRI (those with implants incompatible with MRI), if the diagnosis cannot be made and there is suspicion, they should be closely monitored with CT scans and regular X-rays.
Treatment of Osteoporotic Spinal Fracture
In the treatment of osteoporotic spinal fractures, non-surgical methods are primarily preferred. Among these methods, the use of a brace is common. However, due to insufficient bone quality in most patients, surgical intervention becomes inevitable.
Compared to younger patients, the rate of bone healing in osteoporotic patients is lower. Therefore, in patients with increasing collapse, minimally invasive procedures called vertebroplasty or kyphoplasty are applied. In these methods, the inner part of the fractured and collapsed vertebral body is filled with bone cement, known as cement. This ensures the patient's pain relief in the early stages and prevents further collapse of the vertebral body, sparing the patient from major surgeries.
However, in cases of simple fractures and mild collapses, brace treatment is presented as the first option. In patients monitored with brace treatment, the amount of collapse should be followed with weekly standing radiographs.
In both brace treatment and minimally invasive methods, it is essential for patients to use supportive supplement medications to improve bone quality. For this purpose, patients should be evaluated by an Endocrinology or Geriatrics specialist and started on the most appropriate and potent medical treatment.
Can a Patient Who Has Had an Osteoporotic Spinal Fracture Fracture Another Vertebra Again?
Yes, this situation is quite common. Some patients may experience recurrent fractures in other vertebrae. Therefore, it is vital for patients to strengthen their bone quality.
What Can Be Done to Strengthen Bone Quality?
- Regular exercise
- A balanced diet rich in calcium and vitamin D
- Taking medications under a doctor’s supervision if necessary
With regular monitoring and necessary precautions, the risk of osteoporotic spinal fractures can be significantly reduced.
Can Vertebroplasty and Kyphoplasty Procedures Be Performed Under Local Anesthesia? How Long Does the Procedure Usually Take?
These procedures are performed minimally invasively through incisions of approximately 2-3 mm under imaging guidance. Up to three levels, they are generally performed with LOCAL ANESTHESIA AND SEDATION ANESTHESIA. For more than three levels, general anesthesia is more suitable. For single-level fractures, meaning procedures performed on only one vertebra, the average duration is between 15-30 minutes.
Can Patients Be Discharged on the Same Day After Vertebroplasty?
Yes, patients can be discharged on the same day. However, as most of these patients are elderly and have additional medical conditions, it is more appropriate for them to be observed in the hospital for one day. In the majority of patients, pain is reduced by more than 80% the day after the procedure.
Does the Cement Placed During Vertebroplasty and Kyphoplasty Cause Any Harm to the Body?
If the cement is injected while it is very fluid during the procedure, cement leaks in the form of clots can occur into the spinal canal, surrounding tissues, and even the lungs. It is essential to frequently use imaging during the procedure and, most importantly, to have the procedure performed by experienced hands. These complications are quite rare but can sometimes lead to undesirable outcomes.
In cases where vertebroplasty is performed on multiple levels, specifically more than five levels, there is a higher risk of cement load formation in the lungs. Patients requiring multi-level procedures should be thoroughly monitored during the operation.
In the long term, the cement does not cause any reactions in the body, but as with any surgery, there is a risk of infection. The infection rates in vertebroplasty and kyphoplasty procedures are very low.
Points to Consider
- This information is for informational purposes only and does not constitute medical advice.
- Please consult your doctor or a relevant specialist for any health concerns.
- For more detailed information about vertebroplasty and kyphoplasty procedures, please contact your doctor.