Wednesday, February 27, 2008

Old Fractures--New Hope?

I am commonly asked the following question from referring practitioners: How old is too old when it comes to treating vertebral compression fractures (VCFs).

The answer is they are never too old if the patient is symptomatic from the fracture. Of course, many fractures heal on their own. Also, many old fractures do not cause clinical symptoms because they have healed on their own. For patients that have an older fracture that still causes pain, however, VCF fixation is highly effective.

One of my favorite examples is a patient I treated during my fellowship at the University of Oklahoma Health Sciences Center. This was an otherwise healthy lady in her thirties. She had suffered a single level VCF at from a car wreck about fifteen (15) years before. This was at T12 (one of the most common locations for these fractures).

To be sure, I was skeptical. At this point, I had experienced a lot of success from treating VCFs with vertebroplasty and kyphoplasty. Up until now, though, we had always used MRI as the gold standard for which fractures to treat. This patient's vertebral body had an abnormal shape, but no other signs of a unhealed fracture on MRI. So, her MRI was considered negative.

Her neurosurgeon, however, felt that the pain was due to the fracture. After examining her, we agreed. She had pain that was the classic 10 out of 10 and was worse with axial loading, such as standing and transferring from chairs.

We treated that patient with kyphoplasty and she was pain free afterwards--her postoperative pain level was zero. Since then, I've treated numerous patients with so-called old or healed fractures. I have found that the success rate for VCF fixation is similar to that seen in other patients--nearly 100% success.

So if you or someone you know has an old fracture and your doctor has told you there is nothing that can be done--rest assured that it can be treated. For more information, contact us at

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