When symptoms from a vertebral fracture are severe, rest and pain medication are recommended. In some cases, an over-the-counter pain reliever may be all that is needed, although applying ice to the painful area also may be helpful.

If these measures do not provide enough relief, a short-term course of prescription pain relievers may be necessary. In addition, short-term use of a back brace may prevent painful movements of the spine and reduce the length of required bed rest.

In the majority of cases, the pain associated with vertebral fractures resolves over time with conservative measures. In cases that do not get better with these therapies, surgery may be required. Surgical techniques for treating vertebral compression fractures include percutaneous vertebroplasty, kyphoplasty, and spinal fusion.

Percutaneous vertebroplasty

This minimally invasive technique is used to repair vertebral compression fractures caused by osteoporosis. The procedure involves injecting a special kind of cement called polymethylmethacrylate into both sides of the fractured vertebra.

The procedure is only used for people who have suffered a recent fracture that is solely responsible for their back pain. Potential complications include soft-tissue damage and nerve-root pain and compression. There is a high level of evidence that percutaneous vertebroplasty may not be any better than placebo, and recently the American Academy of Orthopaedic Surgeons issued a guideline recommending that it not be used.

Kyphoplasty

Ideally, kyphoplasty should be performed within two to three months of the occurrence of the fracture. Using a special balloon, the surgeon expands the recently collapsed vertebral body and then fills it with cement.

As with vertebroplasty, possible complications of kyphoplasty include soft-tissue damage and nerve-root pain and compression.

Spinal fusion

In this procedure, bone grafts are used to join together two or more adjacent vertebrae. Spinal fusion may be necessary when back pain does not respond to more conservative treatments or when nerve pressure or severe deformity develops.

Publication Review By: Lee H. Riley III, M.D., and Suzanne M. Jan de Beur, M.D.

Published: 18 Nov 2011

Last Modified: 05 Feb 2015