Spinal surgery

Most vertebral body fractures are treated conservatively, without surgery. In some cases by temporarily wearing a corset. Normal everyday activities are permitted immediately, although lifting and carrying heavy loads should be avoided. There is usually a significant improvement in pain during the first two to three weeks. Radiological follow-up checks are carried out after one, two, four and eight weeks.

If the pain is unbearable or if the fracture shows certain signs of instability, surgical measures are recommended. In the case of an osteoporotic compression fracture (the vertebral body collapses), attempts are made to straighten and stabilise the vertebral body using a special bone cement. If a vertebral fracture caused by osteoporosis is stabilised with cement, the pain usually subsides very quickly. In older patients in particular, this eliminates the need for lengthy pain therapy with pain medication. In certain cases, cementing is not sufficient or the vertebral body fracture leads to symptoms of paralysis or misalignment, the damaged vertebral bodies are fixed from the back using a special screw and rod system. This frees the spinal cord or spinal nerves from fracture fragments and corrects misalignments. In severe, highly unstable cases, the fractured vertebral body is supported in a second procedure by a special implant (vertebral body replacement), which is inserted from the lumbar region or through the thoracic cavity to prevent the screws in the rod system from loosening. Vertebral body fractures without paralysis but with a slight misalignment can be treated minimally invasively via a small skin incision.

For simpler procedures such as fractures caused by osteoporosis, the hospital stay is short and rehabilitation is not necessary. However, targeted physiotherapy is required. In the case of complex procedures, the operation is followed by a rehabilitation stay of a few weeks to several months to enable reintegration into everyday life.

Paralysis can often no longer be influenced surgically, but stabilisation of the spine allows fractures to heal and relieves pain. Follow-up operations are necessary if the fracture grows together incorrectly or not at all, or if the implants loosen. The pain of osteoporosis-related fractures can also be alleviated by stabilising the spine. However, the risk of further vertebral fractures is generally high.