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Question: An elderly family member of mine developed back pain. She went to her doctor who diagnosed her with a fracture in her back. She was placed in a brace, told to rest and given strong narcotics to help with the pain. She is still in a lot of pain. Are there any other treatments to help her?

Answer: There are many different types of fractures that can occur in the back. There is a certain type of fracture called a compression fracture which is very common in the elderly population. As we age, osteoporosis causes our bones to become weaker due to a decrease in the calcium in the bones, leading to compression fractures. Compression fractures can also be caused by tumors that go to the bones. There is a procedure which can be done to stabilize the fracture and reduce, if not eliminate the patient's pain. It is called a vertebroplasty. This procedure has been performed for over twenty years with excellent results. It involves using imaging guidance to place a needle into the fractured bone. A special type of bone cement is then placed through the needle and into the bone in order to stabilize the fracture. Most of the pain that a patient experiences in a compression fracture is because the fracture is not stable. By stabilizing the fracture, most patients have a significant reduction in pain or their pain goes away completely. Many patients are bedridden or in wheel chairs before the procedure but are able to walk out of the hospital after only a few hours. Our experience with vertebroplasty is that in the right patient, vertebroplasty provides excellent pain relief and marked improvement in our patient's daily lives. The procedure is not without risks, but the risks are minimal. As with any procedure, there is a risk of infection. The procedure is performed in a sterile environment to reduce this risk. There is a risk of bleeding, but this is very low as there are no major blood vessels in the region of the procedure. There is a risk that the cement does not go where it is supposed to. This is also very rare as we are watching with x-rays throughout the procedure. As mentioned, the risks are not very common and the benefits of the procedure far outweigh the risks involved. The results can be amazing and many patients often mention they wish they had come in sooner. It is also important to remember that although vertebroplasty provides excellent relief for compression fractures, it does not cure the underlying cause of the fracture, that is, osteoporosis or tumors. Patients should make sure they are being followed by their primary care physician in order to treat the underlying cause and prevent any future fractures.

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