Vertebral Fracture

A vertebral fracture is a break or collapse in one of the bones of the spine, often called a compression fracture when the front of the bone is squashed down. It can range from a painful but stable injury that heals with time to a serious break that threatens the spinal cord and nerves.​

1) What is this condition?

  • It is a crack or collapse in a vertebra, usually in the mid‑ or lower back, that can change the shape and height of the bone.​

  • Many are “compression fractures,” where the front of the vertebra collapses into a wedge shape, commonly due to osteoporosis (weakened bone) or trauma.​

2) How serious is it?

  • Osteoporotic compression fractures are common in older adults and can cause severe pain, height loss, and a hunched posture but often do not damage the spinal cord.​

  • More violent injuries (falls, car crashes) can cause unstable fractures that may press on the spinal cord or nerves and risk paralysis or loss of bladder/bowel control.​

3) Non‑surgical treatments

  • Short period of relative rest (not strict bed rest) and avoiding heavy lifting or bending during early healing.​

  • Pain medicines (acetaminophen, careful use of anti‑inflammatories, and sometimes stronger painkillers for a limited time).​

  • Back bracing for 6–8 weeks to support the spine, reduce movement‑related pain, and help posture.​

  • Physical therapy to improve strength, posture, balance, and safe movement once pain begins to ease.​

  • Treatment of underlying osteoporosis (e.g., bisphosphonates, teriparatide, romosozumab) to reduce the chance of more fractures.​

4) Types of surgery that may be needed

  • Vertebral cement procedures (vertebral augmentation):

    • Vertebroplasty: injecting bone cement into the fractured vertebra to stabilize it.​

    • Kyphoplasty: inserting a balloon to create space, then filling with cement, sometimes restoring some height.​

  • Larger operations for unstable or nerve‑compressing fractures:

    • Decompression (removing bone pieces pressing on nerves or spinal cord) plus fusion with screws, rods, and bone graft.​

5) Goals of surgery vs non‑surgical care

  • Non‑surgical goals:

    • Control pain while the fracture heals naturally and maintain mobility as safely as possible.​

    • Correct or treat bone weakness to prevent more fractures.​

  • Surgery/augmentation goals:

    • Quickly stabilize painful fractures to reduce pain and help return to activity sooner, especially when pain remains severe despite good conservative care.​

    • In unstable or nerve‑threatening fractures, protect the spinal cord and nerves and restore spine stability and alignment.​

6) How surgery can “fix” the problem

  • In vertebroplasty/kyphoplasty, solidifying the broken vertebra with cement reduces micromotion at the fracture, which often eases pain significantly.​

  • Kyphoplasty may also partially lift the collapsed front of the vertebra to lessen forward bend, though height gains can lessen with time.​

  • In fusion surgery, hardware and bone graft create a solid “bridge” across broken segments so the spine no longer moves abnormally at the fracture.​

7) Risks of surgery (general and specific)

  • General risks: infection, bleeding, blood clots, anesthesia complications, and lung or heart issues, especially in frail patients.​

  • Cement procedures:

    • Leakage of cement into veins or around nerves causing nerve compression or, rarely, lung embolism; these events are uncommon but more frequent with vertebroplasty than kyphoplasty.​

    • Possible increased risk of fractures in nearby vertebrae, though studies are mixed.​

  • Fusion surgery:

    • Higher risk of infection, blood loss, hardware failure, and non‑healing of the fusion, especially in osteoporotic bone.​

8) Chances this surgery will work

  • Vertebroplasty and kyphoplasty provide marked or complete pain relief in about 70–85% of patients in many series (including those with osteoporosis or cancer).​

  • Kyphoplasty and vertebroplasty appear similarly effective for pain relief and function, with kyphoplasty sometimes offering better initial height restoration.​

  • For unstable fractures treated with fusion, most patients gain better stability and pain control, though outcomes depend on age, bone quality, and other health issues.​

9) Possible complications from the surgery

  • Cement leakage causing new nerve pain, weakness, or very rarely serious lung or heart problems.​

  • Adjacent‑level fractures above or below the treated area over time.​

  • For open fusion: wound infection, hardware problems, persistent pain, or need for additional surgery.​

10) Typical recovery from the condition

  • Many osteoporotic compression fractures improve over 6–12 weeks with non‑surgical care, though some pain or height loss may persist.​

  • Multiple fractures can lead to long‑term posture changes (hunched back), reduced lung capacity, and ongoing back pain.​

  • Early rehab and osteoporosis treatment are key to regaining function and limiting future fractures.​

11) Typical recovery after surgery

  • After vertebroplasty/kyphoplasty, many patients notice pain relief within hours to days and can often walk the same or next day.​

  • Soreness at the needle or incision site is common for a few days, with gradual return to normal light activities within a week or two.​

  • After fusion or larger decompression surgeries, hospital stays and rehab are longer; full recovery may take several months.​

12) How long in the hospital

  • Vertebroplasty and kyphoplasty are usually same‑day or one‑night procedures.​

  • Larger open surgeries for unstable fractures generally require several days in the hospital, sometimes followed by inpatient rehab.​

13) Long‑term outlook

  • Many people with a single osteoporotic compression fracture recover good function, but having one fracture increases the risk of more unless bone loss is treated.​

  • Persistent pain, height loss, and curvature can reduce quality of life, but targeted rehab and pain management can help.​

  • Treating osteoporosis and fall risks can significantly improve long‑term outcomes and survival.​

14) Need for outpatient follow‑up

  • Regular follow‑up with a spine or rehab specialist to monitor pain, mobility, and posture, and to adjust bracing and therapy.​

  • Bone‑health follow‑up (with primary care or endocrinology) to manage osteoporosis medications and check bone density.​

  • After surgery, follow‑up visits and occasional imaging confirm fracture healing, hardware position (if present), and check for new fractures.