Compression Fracture Management
Minimally invasive treatment of painful vertebral compression fractures and sacral insufficiency fractures
CNS physicians perform a variety of different procedures to treat vertebral compression fractures and sacral insufficiency fractures. Vertebroplasty and kyphoplasty are procedures in which "cement" is injected into the fractured bone to seal and stabilize the fracture, which results in pain relief in 80-90% of cases. Multiple different variations of these procedures can be performed depending on the location, severity, and acuity of a fracture.
Vertebroplasty
A needle is advanced into the fractured bone, and cement is injected until the fracture is sealed and stabilized. 80-90
1. Performed under conscious sedation administered by our nurses.
2. Takes ~20 minutes per level
3. Cement is fully hardened by the time you go home 1 hour later
4. No specific activity restrictions after leaving the hospital
Diagnosis of a Fracture
Compression fractures of the spine and insufficiency fractures of the sacrum cause severe pain and can take 6-12 months or more to heal if treated conservatively (i.e. brace and/or pain medication alone) typically occur in the setting of osteoporosis and some degree of trauma, although
1. X-Ray: Basic imaging technique using radiation that can identify many fractures, but it has limited ability to assess if a fracture is acute or chronic.
2. CT: Advanced imaging technique using radiation to create high resolution image slices through the spine that allows for excellent visualization of the bone, but it has limited ability to identify subtle fractures and to assess if a fracture is acute or chronic.
3. MRI: Advanced imaging technique using strong magnetic fields and RF energy pulses to create high resolution image slices through the spine that all for the identification of even the most subtle fractures as well as readily differentiating between acute and chronic fractures.
3. Bone Scan: Nuclear medicine study that provides a limited anatomic view of the bones, but it readily differentiates between acute and chronic fractures
Treatments for Brain Aneurysms
Ruptured brain aneurysms are usually treated by endovascular embolization (minimally-invasive catheter-based treatment) unless it is technically impossible or too high risk, in which case surgical clipping may be considered.
Unruptured brain aneurysms are usually treated by endovascular embolization (>95% at Ascension Borgess), but surgical clipping may be considered in select cases where it is determined to be safer.
Not all brain aneurysms need to be treated. In cases where the risk of rupture is exceedingly low or the risk of treatment outweighs the benefit, conservative management may be appropriate. Your physician will help you understand your specific situation in order to determine the best treatment for you.
Coil Embolization
A brain aneurysm with a narrow neck is filled with small metal coils to block off blood flow into it
Stent-assisted Coil Embolization
A brain aneurysm with a wide neck is filled with small metal coils, and a stent is placed across the neck of the aneurysm to hold the coils in the aneurysm
Flow Diversion
A technique used to treat wide-necked brain aneurysms in which a special stent with a tight meshwork in the wall is deployed in the parent artery across the neck of the aneurysm to divert blood flow away
Intrasaccular Flow Disruption
A technique used to treat wide-necked brain aneurysms by placing an intrasaccular device into the aneurysm, which alters blood flow into the aneurysm and leads to its closure
