Wednesday, January 19, 2011

Chronic Vertebral Fractures--do they respond to therapy?

The Question--Chronic Fractures

I had a question today from a chiropractor regarding so-called chronic vertebral compression fractures (VCFs). In particular, this regarded a patient with a 3 year old fracture.

The Answer Is Easy

Let me be clear--in my experience, as long a vertebral fracture is clinically symptomatic, it has a near 100% success rate with vertebroplasty or kyphoplasty. By symptomatic, I mean that the patient has a fracture, has back pain and has tenderness to palpation or percussion at the spinous process.

Belt Line Pain Syndrome

Often, folks will present with remote fractures at the thoracolumbar junction, commonly T11-L1 sustained in a car crash perhaps 20 years or so ago. However, their main complaint of back pain is lower, often described as "belt line pain". My theory is that this is due to chronic paraspinal muscle spasm due to the fracture. Why? Because this, too, goes away immediately after fixing the fracture. In fact I've had 2 patients this month with that exact phenomenon.

I have personally fixed fractures up to 35 years old with complete pain relief afterward.

Medical Literature

Some notes from the medical literature regarding chronic fractures. These are often overlooked our flat out ignored by most doctors--
1. 94% success rate for vertebroplasty on fractures <1 year old
2. 80% success rate for vertebroplasty on fractures >1 year old.

I would love to discuss more. Feel free to contact me at or call our office at (918) 260-9322.

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