What is a Vertebral Body Fracture?
Vertebral body fractures explained by Denver, Golden, Aurora, Boulder, Broomfield, Jefferson, and Littleton Colorado’s top pain doctors
Major damage to the vertebrae (bones of the spine) can be associated with paralysis or death in many cases, due to the resulting serious injury to the spinal cord. Minor vertebral fractures are rarely fatal, but often result in chronic pain of the back or neck. The larger part of an individual spinal bone is called the vertebral body, on which the intervertebral disc sits. Most of the vertebral body faces away from the spinal cord into the body. Many cases of minor fractures are seen in this area. While not usually life-threatening, they can cause chronic pain and a decrease in normal function and mobility. Vertebral body fractures are most often sustained in the thoracic, lumbar, or sacral spine, that is the upper or lower back.
Causes of Vertebral Body Fracture
There are two main types of vertebral body fractures, “splits” and “bursts.” “Splits” are singular breaks along or within the vertebral body. “Bursts” are a number of very small fractures that often give the vertebral body the appearance of having been cracked into several small pieces. Both are associated with activities that may compress the spine, such as diving, firearm-related injuries, or motor accidents. A fall from a height may also cause a vertebral body fracture.
Both “splits” and “bursts” are commonly associated with people of 55 years or more. Younger men (15-24 years) are also particularly at risk for these injuries, as this demographic is strongly linked with high-impact recreational activities that may result in vertebral body fractures. These, or fractures caused by accidents or other violent trauma, should be addressed by immediate medical treatment. Some types of bone cancer or osteoporosis can also cause vertebral body fractures, due to a lack of bone density. Ankylosing spondylitis, a condition causing inflammation in the central skeleton, is also associated with an increased risk of vertebral fractures. Vertebral body fractures can cause spinal cord injuries or paralysis if left untreated, and may be a source of chronic pain.
Treatment of Vertebral Body Fracture
A popular and conventional treatment for vertebral body fractures is vertebroplasty. In this procedure, the skin above the affected bone is anesthetized. A thin needle is then inserted into the bone, and medical cement is injected. This fuses the fracture(s). A similar surgery is called kyphoplasty. In this procedure, a small balloon is inserted through the needle and then inflated to support the bone. Then, cement can be injected if necessary. These procedures carry minimal risks, such as bleeding and infection, at the needle insertion site. There is also a slight possibility of cement leak from the vertebra that can result in tissue damage and inflammation. This may be a source of chronic or acute pain after the surgery. Vertebroplasties in older patients may increase the risk of another type of spinal bone fracture, called a compression fracture.
If vertebroplasty is not necessary, other options to manage the pain of the fractures may be recommended. These include conventional medications, e.g. non-steroidal anti-inflammatory drugs (NSAIDs). Nerve blocks are injections of local anesthetics, such as lidocaine or steroids, delivered to inhibit spinal nerves that signal pain in cases of vertebral body fracture. This is an effective method that significantly reduces chronic pain for weeks to months. Radiofrequency ablation (RFA) is another procedure used to reduce pain associated with vertebral body fractures. This technique involves the insertion of thin probes emitting electro-thermal impulses through the skin, under local anesthetic. These probes, guided by imaging equipment such as magnetic resonance imaging, specifically target the regions of spinal nerves transmitting pain signals and destroy them. This procedure also includes risks of bleeding and infection. There is a very low incidence of inaccurate RFA probe insertion that may lead to nerve damage, causing numbness or paralysis.
Vertebral fractures can be a fatal condition, due to their potential effects on the spinal cord. The larger part of a spinal bone is known as the vertebral body that holds the intervertebral disc. Fractures in this region rarely result in death, but can cause chronic pain and spinal cord damage if left untreated. There are two main types of these: “splits” or “bursts.” Both can be caused by trauma, such as that following a motor vehicle accident. They are also associated with low bone density, which can be associated with osteoporosis or bone cancer.
Vertebroplasties or kyphoplasties can repair vertebral body fractures. If these surgeries are unnecessary, nerve-blocking injections or painkillers may control the pain of vertebral body fractures. Radiofrequency ablation may also prevent pain in this condition.
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