Kyphoplasty/Vertebroplasty
Kyphoplasty/Vertebroplasty is a more recent approach to compression fractures of the spine. This involves injecting a bone cement under pressure into the collapsed vertebral body, in effect to restore height by forcing the bone fragments into a more pleasing anatomical alignment.
Vertebroplasty is the injection of bone cement inside a collapsed vertebra
The long term effects of vertebroplasty are unknown, since even in a somewhat crushed state the vertebral body still houses the rich blood capillary bed from which the intervertebral disc sucks in its vital nutrition. Early studies indicate accelerated breakdown of the adjacent intervertebral disc with this procedure. Bursting the injured vertebra is also a complication, as the picture below shows.
A kyphoplasty is a similar surgical procedure for wedge compression fractures of vertebrae in the thoracic spine and the same limitations apply. As a postural stoop becomes more apparent in advancing years, spontaneous fractures are commonplace in the thoracic spine.
Principles of conservative treatment of spine compression fractures
Less invasive treatment for traumatic compression fractures is bed rest. One cannot naturally restore the height of the crushed vertebra, although with the right management this may modify considerably over time. The main objective during the healing phase of the crushed bone, is preventing any future deformity of the skeleton as a whole. With wedge fractures, it is important to maintain upright alignment of the spine by preventing the upper body tipping forward and becoming fixed in front of the line of gravity.
Keeping the spine straight while a wedge fracture mends is important for the health of the spinal segments both above and below the damaged vertebra. The best approach in the acute post-injury stage is six weeks lying as flat as possible to stop the spine bending while bone bone is uniting. A more old-fashioned approach was using a plaster-of-Paris jacket to encase the body from armpits to hip bones for a similar period. The results were no better, if not worse, from the massive de-conditioning of the muscles when the spine emerged from the plaster jacket.