Vertebral Compression Fracture
If middle-aged and elderly people experience severe back pain after slipping or falling to the ground, and it is difficult to turn over, especially when sitting or standing up, it is highly suspected that a "compressive fracture" may have occurred in the spine. Compression fractures are caused by the collapse of the vertebral body due to the inability of the vertebral bodies to bear the vertical force. They mostly occur in patients with osteoporosis and are often caused by minor trauma; patients with normal bone density are often caused by accidents such as falls from heights and car accidents.
Because the fracture is unstable, any time the spine rotates or stands upright to bear weight, it can cause severe pain. Therefore, the most important principle in the treatment of spinal compression fractures is "fixation". Patients should stay in bed as much as possible at the initial stage to reduce the load on the spine. As long as they sit up or get out of bed, they need to wear a back brace for external fixation, such as putting plaster on the spine. The reason is the same. Under conservative treatment, it takes about three months for the spine to gradually heal to a sufficient and stable strength. As the fracture gradually heals, the back pain will further improve, and the time for getting out of bed will gradually increase.
The operation process is guided by X-ray images, and the puncture needle is introduced into the collapsed vertebral body from behind, and the flowable bone cement is slowly injected through the guide needle to fill the vertebral body space, and the vertebral body can be provided after the bone cement hardens. sufficient stability of the body. The operation takes about 30 minutes, local anesthesia is required at the needle insertion site, the blood loss is very small, and the wound is less than 1 cm. Most patients experience significant pain relief after the operation and can get out of bed within one hour after the operation. The risks of surgery include bone cement leakage, hematoma at the puncture site, and wound infection, etc., but the incidence rate is not high when performed by experienced doctors. However, severe bone cement leakage may still cause spinal nerve compression, which may lead to Pain and even paralysis of the lower limbs.
Percutaneous kyphoplasty (or kyphoplasty) is modified from vertebroplasty. The operation steps are the same, the difference is that a catheter with a balloon at the front is used to expand the collapsed vertebral body Reset, take out the balloon and fill it with bone cement. The advantage is that most of the collapsed vertebral body can be corrected, and the chance of bone cement leakage is also reduced, making the operation safer. The disadvantage is that the cost is relatively high, and the balloon device is currently not covered by health insurance. Whether it is vertebroplasty or vertebroplasty, compared with the traditional surgery of implanting bone nails and internal fixation, it is a minimally invasive, fast and relatively safe treatment method.
Finally, regardless of whether bone cement is perfused to accelerate fracture recovery, patients with compression fractures must subsequently change their living habits, exercise more, spend more time in the sun, eat foods rich in calcium and vitamin D, and use osteoporosis drugs to delay the recovery. Bone loss can reduce the chance of another fracture.