Advances in technology make it possible for doctors to repair broken vertebral bones. This type of fracture is called a vertebral compression fracture. The break can be repaired by injecting cement right into the bone. A special tool is inserted through the skin and soft tissues to the center of the vertebra. This treatment is called a percutaneous vertebroplasty.
This method can’t be used when fractures are severe. In such cases the vertebroplasty can be done using an imaging X-ray called fluoroscopy. A special microscope is also used to guide the doctor. A small opening is cut between the lamina from behind. The lamina is the bone that forms the back arch of the canal around the spinal cord.
With this small opening the doctor can see more and avoid putting pressure on the spinal cord. It’s possible to guide the tool to the right spot and remove any cement that spills over or leaks out. This method gives doctors better control over what happens without fully opening the spine or damaging the nearby soft tissues.
Doctors in Germany report the results of using this approach with 24 patients who had severe osteoporotic fractures. They all had severe back pain. Some had symptoms of nerve pressure such as numbness, weakness, and leg pain. Follow-up showed excellent or good pain relief in 73 percent of the patients. The authors think this is a good success rate given how severe the fractures were.
Severe fractures of the spine can sometimes be repaired without major, open surgery. The microsurgical approach described in this study makes it possible to treat very old patients with severe collapse of the spinal bones.