According to Thai population demographics, Thailand is transitioning to “the aging society”. At present Thai women have an average life expectancy of 80.4 years whereas for Thai men is 73.2 years. One of the inevitable consequences of aging is the risk of osteoporosis, causing weakened bones and fragility fractures particularly in the spine.
Osteoporotic vertebral compression fracture is an acute condition which requires expeditious treatment to minimize disability and the risk of serious complications. According to studies, one-year mortality after osteoporotic vertebral compression fracture is as high as 11%.
Causes
This condition may unexpectedly result from low impact trauma in the elderlies such as a slip and fall landing on the buttock in a bathroom, falling out of bed, or being bumped against car seat when the car hitting a pothole.
Symptoms and diagnosis
Seek medical care if you experience symptoms such as back pain (often in the thoracic spine where fractures commonly occur), inability to move, sit or stand on your own, severe pain with motion which improves when staying still. If the vertebral fractures compress on spinal nerves, you may experience numbness or muscle weakness in the lower trunk and extremities as well as fecal incontinence. See your doctor for a thorough investigations to determine whether you have sustained osteoporotic vertebral compression fracture.
Treatment
The treatment modalities depend on the severity of the vertebral compression fracture and the extent of spinal nerves injuries. With no spinal nerve compressions, the initial treatment can be taking pain killers, wearing a back brace to prevent increased compression fractures, along with treating osteoporosis. If symptoms do not improve, balloon kyphoplasty may be considered. Balloon kyphoplasty involves injecting special cement to halt further collapse of the vertebra and restore its previous height as much as possible. More importantly, it significantly reduces pain and allow you to resume your daily activities faster.
Image A: Balloon kyphoplasty procedure
Image B: Plain radiograph of thoracic spine showing collapsed osteoporotic vertebra (yellow lines)
Image C: Vertebral height restoration of collapsed vertebra after balloon kyphoplasty with cement injection
