|2009-10-16|  Question: I am 65 years old and have osteoporosis. I recently slipped down a flight of stairs and started having extreme mid back pain. I underwent x-rays, which showed a compression fracture at the T 8 vertebra. I have tried anti-inflammatory medications, rest and a back brace without much relief. What other options do I have to relieve this agonizing pain?

Answer: Compression fractures of the vertebral body, a thick block of bone located on the front of each spine vertebra, are usually caused by trauma affecting soft or osteoporotic bones. Osteoporosis, a disease that attacks bone and causes the spine to weaken and become brittle, is one of the primary causes of compression fractures. The vertebral body becomes so thin it can break from simple movements such as twisting, bending, and even coughing. These can be easily diagnosed by X-rays. Usual treatment for vertebral compression fractures include oral analgesics, avoidance of spinal motion such as flexion, spinal orthotics, and activity modifications. When these modalities fail, percutaneous vertebroplasty presents a viable alternative. This involves injecting a fluid through a needle. "Plasty" means to mold or form. Thus, vertebroplasty helps mold the vertebrae by injecting a fluid in the bone. The fluid is a bone cement mixture that hardens, strengthens and stabilizes the vertebra in order to prevent further collpase, and in essence relieves the pain. Most patients report pain relief within 24 to 72 hours and between 70% and 80% have sustained pain relief.

Jafar W. Siddiqui, MD
Physiatry and Interventional Pain Management