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Monday, March 10, 2014
Spine and Back Health
Crushed Thoracic Vertebrae
Is vertebroplasty an option for anyone who has crushed/compressed thoracic (t10-t11) vertebrae, resulting from a MVA, or is this procedure only for those with osteoporosis? a friend has been told that approx. 80% of his t10 vertebrae is crushed/compressed. He`s been in a back brace, restricted mobility and pain meds for six weeks now. He`s been told to either let his back heal on its own, or undergo spinal fusions. How could someone with 80% crushed bone heal on its own, along with losing about an inch in height?
Lastly, besides surgery, are there any alternative medicine treatments/holistic treatments that are effective with natural bone healing and reducing/eliminating pain? Thank you.
Hello, thank you for your question. Firstly, I do not recommend vertebroplasty at all. Kyphoplasty is a similar procedure but safer, with lower risk of cement leakage. So, if you will allow me to modify your question to ask whether kyphoplasty is an option for non-osteoporotic, post-traumatic compression fractures the answer is 'yes'. I have done many of these procedures for younger patients with traumatic compression fractures, usually with very good results. It is extremely important that the fracture be a compression fracture, not a burst fracture (they are similar, but a burst fracture is more extensive and would require a fusion as a kypho/vertebroplasty would be unsafe).
The reality is that the vast majority of these fractures will heal on their own, and don?t need surgery, unless one of three things:
1. There is a neurological deficit (numbness or weakness in the legs).
2. There is severe, unmanageable pain despite a brace and pain medication.
3. There is marked kyphosis (abnormal forward curvature of the spine at the level of the fracture).
Usually the 80% number refers to the 'loss of height' of the vertebra, not the proportion of the bone that is fractured. So, if the bone was originally 3 cm high, it would now be 0.6 cm high. This is a lot of LOH (loss of height), but still should heal. Yes, the person might be a tad shorter, but bear in mind that rarely does surgical treatment make the person go back to their original height. Most fractures will heal within about 6-8 weeks in a non-elderly person.
Your last question is more difficult. I'm not an expert on holistic treatment. I'm sure there are lots of pain treatments out there, just be sure it's something safe. As far as the bone healing, a healthy diet with enough vitamin D and calcium, and NO SMOKING!!! are the best ways to promote good bone healing. Smoking is devastating for bone healing. I hope these comments help. Best of luck.
David J Hart, MD
Associate Professor of Neurosurgery
School of Medicine
Case Western Reserve University