Can you tell me what a wedge fracture is? My 88-year-old mother has six wedge fractures of the spine. It's very painful, and she's getting all hunched over because of it. Can anything be done?

Posted April 4th, 2008 by Matt

Spine General (involves multiple spine areas)

A wedge fracture means the front part of the vertebra is compressed down. The diagnosis is made by X-ray. From the side, the bone looks like a wedge-piece of pie. The middle and back portion of the bone remain unchanged.

The fracture is graded as mild, moderate, or severe. Mild means that 20 to 25 per cent of the vertebrae is compressed. With moderate compression, the vertebral height is reduced by 25 to 40 per cent. Severe compression is anything more than a 40 per cent loss of bone height.

As the front of the bone collapses, there is a tendency for the entire spine to curve forward. This gives the person the characteristic humpback posture. Even older adults can benefit from treatment. Bracing is often advised but so uncomfortable, the patient stops wearing the corset or brace.

Pain relievers may be helpful. The new bone building drugs like Fosamax or Boniva may be prescribed. A minimally invasive procedure called percutaneous vertebroplasty (PV) is quickly becoming the standard treatment for this condition.

A long, thin needle is inserted through the skin down into the bone. When the tip of the needle is in the center of the vertebrae, the surgeon injects enough cement to fill the space. Once the cement hardens, the bone is stable and pain may be relieved. If the compression is too severe, kyphoplasty may be tried.

In kyphoplasty, once the needle is inserted, a balloon is placed inside the center of the bone and inflated. The balloon is deflated and cement is injected inside the space made by the balloon. This procedure helps restore the height and shape of the vertebra to a more normal position.

If possible, make an effort to discuss treatment options with her doctor. Consider going with her to a follow-up appointment to find out what can be done. Her age, general health, and any other risk factors will be taken into consideration. Seniors don't have to suffer needlessly. There are ways to help manage this problem successfully.

Shi-Cheng He, MD, et al. Repeat Vertebroplasty for Unrelieved Pain at Previously Treated Vertebral Levels with Osteoporotic Vertebral Compression Fractures. In Spine. March 15, 2008. Vol. 33. No. 6. Pp. 640-647.

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