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My 85 year old father has suffered several compression fractures in his thoracic spine following a recent fall. What are the options for treatment for him?

In a recent article by Chroma,et al, several common spinal injuries that occur in the older adult were assessed. Vertebral compression fractures are common in the elderly patient often due to loss of bone strength, also known as osteoporosis. Treatment options to decrease pain and improve function include conservative care, meaning possibly medications to control pain and physical therapy to address exercises and stretches. There two surgical procedures, called vertebroplasty and kyphoplasty, inject cement into the collapsed vertebral body to stabilize the area. However, the research on these procedures is mixed at best, showing minimal improvements in pain compared to non surgical treatment and an increased risk of cement leakage. The current American Academy of Orthopedic Surgeons guidelines for treatment following vertebral compression fracture are; use of calcitonin in the first four weeks following injury; recommend against vertebroplasty and only weakly recommend kyphoplasty. The article does state that more recently there have been some studies showing improved outcomes with kyphoplasty and vertebroplasy including a four year Medicare study which showed that survival rates were around sixty one percent with surgery opposed to fifty percent without.

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