April 6, 2022

MIS Compression Fracture

Paying Attention to Posture: Signs of a Spinal Compression Fracture

Have you noticed a sharp or continual pain in your back, or a change in your posture, height or muscle volume? There’s a chance the symptoms you’re experiencing are actually caused by a compression fracture of the spine. A compression fracture typically occurs when a vertebral bone in your spine has decreased in height due to fracture. Thus, a part of your bone has been compressed into itself and is making you feel localized pain in one specific place in your back or is even causing posture-altering deformities. 

Osteoporotic patients might fracture a vertebra by simply sneezing or lifting something heavy, while patients with healthy spines usually experience a significant trauma, like a hard fall, sports injury or other accident.

Non-Surgical Treatments

These injuries are common in the upper back but can occur in any vertebrae. Luckily, the damage resulting from fractured vertebrae is usually isolated and does not affect the surrounding nerves or the remainder of the spinal cord. While an isolated spinal fracture typically heals on its own 3-6 months, the effects of this fracture can be more than just physical. Although this condition is treatable and its effects can generally be reversed with timely diagnosis, the change in patients’ appearance can alter their self-image and mental health. It’s important to understand that any deformity or change in posture isn’t your fault, and it isn’t a flaw. We can help talk you through bracing and surgical options to reverse any spinal deviations that result from your injury. 

In patients experiencing pain but not altered posture, we often prescribe activity modification, pain medication and/or bracing. An injury such as this might call for low-impact or low-mobility workouts. Gentle exercises can help stretch your back muscles and reduce possible spasming resulting from the fracture. Once you’ve been diagnosed, our providers will advise a physical therapy or activity regimen on a case-by-case basis.

Surgical Treatments

If you ignore or misdiagnose your injury for too long, localized pain can expand to affect the rest of your body. Untreated or extreme cases in which the nerves/spinal cord have been affected have very different, notable symptoms: pain, numbness or weakness in the arms and legs. In cases such as these, the pain is radiating into your extremities due to nerve damage. This can be the result of radiating, radicular or referred pain. 

To put it simply: 

  • Radiating pain travels from one point in the body to another larger part–like from your back to your arm or leg.
  • Radicular pain extends from your back and hip into legs via the spine, traveling along the spinal nerve root. This leg pain is often accompanied by numbness, weakness and tingling. 
  • Referred pain occurs when the pain you experience in one body part is caused by injury or pain in another body part. 

In extreme cases such as this or when the posture has been severely altered, surgery is a treatment option worth considering. At miiSpine, our providers typically recommend one of three surgical operations for a compression fracture: a kyphoplasty, SpineJack procedure or posterior fusion. 

Kyphoplasty, or balloon vertebroplasty, is a minimally invasive procedure used to repair a vertebral compression fracture and restore the natural shape of the spine. A needle inserted into the back places and inflates a tiny balloon in the vertebral body to expand the fractured bone. Once deflated, the balloon leaves a small cavity in its place, and the balloon is removed. After its removal, the provider will inject bone cement into the cavity via the needle. This cement will harden and stabilize the fracture.

A SpineJack procedure involves a similar process. Meant to be used in tandem with acrylic bone cement, the SpineJack seeks to provide anatomical restoration and give surgeons even better control over bone height and expansion. The SpineJack implant also comes in three different sizes to accommodate for various anatomical sizes and fracture types. Made of titanium and resembling a car jack, a needle is inserted into the spine and the implant is situated in the fractured vertebral body. From there, the implant is expanded to restore the spine to its natural height. Then, a second matching implant is inserted and expanded on the other side of the fractured vertebral body. After locking each into the desired position, the surgeon will inject bone cement to stabilize the restored vertebra. The implants will be encapsulated by the bone cement. 

Posterior fusion aims to permanently join two or more vertebral bones. In creating a solid mass of bone, the operation stabilizes the spine. If this surgery is intended to relieve pressure on your spinal nerves, the surgeon might have to modify your spine–the surgeon might have to remove all or part of the lamina from a vertebra, creating space for the nerves. To create the fusion, your surgeon will use a bone graft, likely from your own hip, or from a donor. Next, the surgeon will remove some bone from the surface of the vertebrae to make room for the graft’s placement and growth. Using hardware such as screws, rods or plates, the surgeon will stabilize your spine and lock the vertebrae together. Once the spine is stabilized, the graft will be placed against the vertebrae. After the procedure is complete and the incision is closed, a provider will recommend wearing a brace to allow bone growth with minimal disruption. As the bone permanently solidifies, we might prescribe a physical therapy regimen to ensure a healthy healing process. 

Each of the three surgical procedures combat compression and bring stability. These minimally invasive options use varying approaches to heal the fracture and reduce your pain. The main differences are found in incision sizes and healing times. Kyphoplasty and SpineJack procedures are performed via small punctures in the skin rather than a large open incision, whereas posterior fusion involves a slightly larger incision. 

While we happily perform these three surgical treatments to relieve our patients’ pain, it’s always preferable to treat an injury as soon as you begin to show symptoms. The earlier we can diagnose and respond to your pain, the better. Make an appointment to visit our office today, and we can evaluate your symptoms and create the treatment plan that’s right for you.

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