Fracture
Fractures of the spine are either traumatic (caused by an accident) or osteoporotic (insufficiency fracture).
Traumatic vertebral fractures are mostly unstable and need to be stabilised with an operation.
In osteoporotic fractures, two problems arise:
- Forming of a kyphosis and instability
- strong pain
Treatment
In general, osteoporotic fractures can be treated conservatively. This includes treatment of pain, immobilisation and bed rest, as well as clarification and treatment of osteoporosis.
Indication for surgery
In an insufficiency fracture, the pain can be too strong for the patient to be mobilised. In this case, an operation is necessary. If a patient is confined to bed due to his pain, the risk of thrombosis and pneumonia is high. An operation is indicated to ease the pain.
Operation
In an insufficiency fracture the injection of bone cement into the broken vertebra is usually enough to ease the pain immediately, enabling the patient to be mobile. A fixation with screws is only necessary in rare cases.
A traumatic fracture on the other hand, always requires a fixation with screws for stabilisation.
Example 1: Injection of bone cement into a broken vertebra (vertebroplasty) in an insufficiency fracture due to osteoporosis
Example 2: Operative stabilisation of an unstable, traumatic fracture