Bone damage in the spine is an unarguably serious condition. Total breaks or dislocations in the cervical spine (i.e. the neck) often result in death or paralysis, due to the extreme damage to the spinal cord they cause. However, minor fractures can be survived, but will cause Chronic Pain in the neck or back. The vertebral body is the main part of the bone, where the intervertebral disc is also located. This disc supports the vertebra above it. Most of the vertebral body faces into the body cavity, in front of the spinal cord.
Fractures (splits or bursts) in the vertebral body are usually a consequence of motor accidents, firearm-related injuries, or diving. Splits are single fractures through the vertebral body. Bursts are multiple fractures that appear as though the bone has shattered into small pieces. Both types most often occur in men 15-24 years and people of 55 years or older. Vertebral fractures are often the result of car accidents, falls, or other traumas. In these cases, medical treatment should be sought straight away. Fractures are also associated with some bone cancers in the body of the vertebra and with osteoporosis. This is a loss of bone density that increases the probability of bone fractures. Vertebral fractures are a source of chronic pain, and may cause spinal cord injuries and/or paralysis if left untreated.
Vertebroplasties are effective in repairing spinal fractures. They have minimal risks, such as infection and bleeding at the site of needle insertion. There is also the possibility that the cement may “leak” out of the bone, causing inflammation and thus further pain. Another risk factor is that procedures carried out on the spines of older patients may increase the probability of another type of vertebral fracture—a compression fracture. These are associated with osteoporosis.
Another technique to reduce pain in conditions such as vertebral body fractures is radiofrequency ablation. This technique involves the introduction of thin probes through the skin to spinal nerves. These deliver electro-thermal impulses to destroy the pain-transmitting fibers of nerves. This prevents the pain of fractures being conducted to the brain. Much like vertebroplasty, this procedure carries the risk of infection and bleeding. Ablation may also cause inadvertent motor nerve damage that can result in paralysis.
If the fractures are not a threat to the spinal cord, other treatments that manage the pain arising from them may be considered instead. These include oral painkillers such as non-steroid anti-inflammatory drugs (NSAIDs). Nerve blocks are injections of steroids and local anesthetics such as lidocaine, given via needle directly to spinal nerves that are the source of pain. Targeting nerves in the lower back are effective in pain relief for patients with fractures.
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