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I just got a phone call from my brother saying that Mother is in the hospital. Surgery is planned for a pathological fracture of her spine. What kind of a fracture is that? What kind of surgery is done?

Pathologic means the person did not have an accident, fall, or other trauma that caused the bone to break. It fractured just during regular activities and movement. Sometimes, all it takes is to roll over in bed and the bone breaks.

This type of fracture is most common in the person who has osteoporosis. Osteoporosis describes a condition of brittle bones from decreased bone mass. It is a result of aging. In women, osteoporosis occurs in conjunction with menopause.

One other common cause of pathologic vertebral fractures (PVFs) is cancer that has metastasized to the bone. With better treatment for cancer, many patients live longer. But they are also more likely to develop spinal metastases.

Treatment may be bedrest and pain relievers. The underlying problem should be addressed. For example, medications and exercise for osteoporosis. Bracing is used for some patients to help support the spine while it heals. Rehab under the direction of a physical therapist may be advised.

When pain and disability persists, surgery may be needed. A minimally invasive surgery (MIS) called vertebroplasty is a common approach. The surgeon inserts a long, thin needle into the fractured bone. A fast-drying, liquid cement is injected into the area and fills the cracks of the vertebra.

A similar operation called a kyphoplasty can also be done. In this case, a tiny, limp balloon is inserted into the bone and inflated. This helps restore the height and shape of the bone. Then the cement is injected to hold the bone in place until it heals. Spinal fusion is a third surgical option needed by some patients.

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