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The spine is the most common site of osteoporotic fractures, the thoracolumbar spine is more common, and the fractures mainly occur at the transition of the thoracic or lumbar spine, with the most common site being T12, followed by L1. The upper thoracic spine can sometimes occur but cervical spine fractures almost never happen.
OVCF tends to occur in elderly patients, and women are more common. Because of osteoporosis in the elderly, “fragile fractures” are prone to occur–fractures can occur under slight external force. This kind of fracture is not only easy to occur during daily activities and exercises, but also occurs in some elderly people with severe osteoporosis, even holding a basin of water, bending down, or even sneezing.
For the elderly who still suffer from severe pain after bed rest after fracture, minimally invasive surgery with minimal trauma can be chosen: percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP). It is currently the first-line treatment for OVCF.
The operation is mainly to inject medical bone cement into the fractured vertebra through a percutaneous minimally invasive channel (diameter not exceeding 0.4cm) under the monitoring of the imaging system, which can quickly relieve fracture pain, enhance the strength of the diseased vertebra, and even restore part of the vertebral body height to prevent further collapse and deformity of the vertebral body.
①PVP: refers to a minimally invasive spinal surgery technique that injects bone cement into the vertebral body through the pedicle or outside the pedicle percutaneously.
②PKP: It is the improvement and development of PVP. PKP refers to a method of percutaneously inserting an expandable bone expansion balloon into the vertebral body through the pedicle or pedicle outward, and then injecting bone cement into the balloon.
Vertebral body strengthening surgery is a minimally invasive surgery, with short operation time and small trauma, which can effectively shorten the patient’s bed rest time. The operation is completed under local anesthesia. A small incision of about 2-5mm is made on the back, and a special puncture needle is used to puncture through the skin into the vertebral body under X-ray monitoring, and bone cement is injected into the vertebral body. Surgical trauma is very small, and the general body can bear it. If the prone position cannot be tolerated, surgery can also be performed in the lateral position.
Advantages of Percutaneous Vertebral Augmentation:
1. Strong and Stable
Enhances vertebral body strength and stability
Restore the height of the vertebral body and prevent collapse
2. High Security
Compared with traditional open surgery, the incision is small, causing less trauma and complications.
3. Pain Relief
Compared with traditional conservative treatment the effectiveness of percutaneous vertebroplasty, the rate of postoperative pain relief and functional recovery is as high as 90%-95%
4. Lighten the Burden
Patients can go back to the ground the next day after surgery. Avoiding the pain and associated complications of prolonged bed rest.
The pathological basis of OVCF is osteoporosis, and surgery only targets local lesions. Therefore, in addition to fracture treatment, systematic anti-osteoporosis treatment should be actively taken to relieve pain, inhibit acute bone loss, increase bone mass, improve osteoporosis quality and reduce the incidence of refracture.
Besides surgical treatment, comprehensive treatment includes health education, basic measures, exercise therapy, fall prevention, basic bone supplements and anti-osteoporosis drugs.
1. Healthy lifestyle
Adjusting lifestyle and ensuring a rich and balanced daily diet are the basic lifestyles for the prevention and treatment of osteoporosis. At the same time, you should adhere to a low-salt diet, drink plenty of water, and keep your stool unobstructed to increase your appetite and promote calcium absorption. Pay attention to smoking cessation, limit alcohol, and avoid excessive drinking of coffee and carbonated drinks.
2. Exercise
Physical inactivity can lead to disuse osteoporosis, and physical activity stimulates bone mass growth. It is generally believed that only load-bearing exercise has a positive effect on bone, and it can also prevent the loss of bone mass in load-bearing bones.
Exercise can improve the flexibility and general condition of the body and reduce the fracture rate.
3. Essential Supplements for Bone Health
Calcium and vitamin D are the basic medicines for daily prevention and treatment of osteoporosis.
4. Anti-osteoporosis drugs
For patients with vertebral fragility fractures, regardless of whether their DXA bone density test results meet the diagnostic criteria, anti-osteoporosis drugs should be administered.
In short, for osteoporotic vertebral fractures, in addition to the treatment of vertebral fractures, anti-osteoporosis treatment, exercise and keeping a healthy lifestyle must not be forgotten, and anti-osteoporosis treatment should run through the entire treatment process.