Compression fractures due to osteoporosis occur to quite a great number of people annually. The most frequent among them are hip fractures resulting in prolonged disability and severe pain.

Osteoporosis is a "silent" disease that affects most of the elderly people - 80 percent of whom are women. Osteoporosis is the leading cause of vertebral compression fractures - injuries that occur when bone tissue inside the vertebrae of the spine breaks and then collapses, sometimes causing severe pain. The condition is characterized by deterioration of bone tissue, which weakens the bones and makes them susceptible to fractures. Vertebral compression fractures affect approximately 2% of the general population each year, and can occur even when doing simple activities, like bending or twisting.

Spinal metastatic disease is very common in patients with cancer. The goals of therapy are pain control and functional preservation. Kyphoplasty and spondyloplasty are minimal invasive procedures that play a crucial role in the treatment of spine metastatic disease.

Fracture Treatments:

Typically, the first line of treatment for vertebral compression fractures is conservative therapy (non-surgical), which includes pain medication, calcium and vitamin D supplements, rest (but only for a short time period, as prolonged inactivity can lead to further bone loss), and external bracing. Pain from the spinal fracture can last for several months while healing, but if it heals well with conservative treatment the pain will usually improve significantly within a few days or weeks.

The procedure known as balloon kyphoplasty is commonly done under general anesthesia in an operating room, although kyphoplasty can also be done under a local anesthesia.

In kyphoplasty:

• The patient is positioned face down (prone) on the operating table.
• A balloon catheter, similar to the one used in angioplasty of the heart, is guided into the vertebra using X-ray guidance, and inflated with a liquid under pressure.
• As the balloon inflates, it can help to actively restore the collapse in the vertebra due to the fracture and can also correct abnormal wedging of the broken vertebra.
• Once the balloon is maximally inflated, it is deflated and removed, and the cavity created is filled with thicker bone cement under lower pressure than in a vertebroplasty.

• Despite being minimally invasive, these cement injection procedures are not without significant risks, so the decision to use these procedures is made on a case-by-case basis and should not be taken lightly.
• The most common complication is leakage of cement out of the vertebra with injection and before final hardening. The potential for this complication is why X-ray guidance is used to visualize the cement while it is being injected.
• If the cement leaks back into the spinal canal it can compress the spinal cord and nerves, causing new pain and neurological problems.
• There have also been rare case reports of pulmonary embolism of the lungs and even death associated with these procedures.