Question
Dr. Leatherman,
My mother fell this past weekend on her kitchen tile.  She landed back first and ended up with a compression fracture on her T-11 vertebra.  It was compressed by 25%.  I was reading about Vertebroplasty.  When should that procedure take place and under what circumstances?  My mother is 52 and in very good health.  
Thanks,
-the worried daughter, Heather

Answer
Dear Heather,

Vertebroplasty is a very effective and minimally invasive procedure that should be performed in a relatively short period of time after injury...all the literature I have read on this topic state that it cannot be performed after 8 weeks post injury, so you have some time.

However, the neurologist or interventional radiologist should help you make that determination.  Since the compression fracture is at 25%, this is like an artificial threshold for performing the procedure.  If it was worse they would surely go in an try to create more height in the vertebra.  But if she is not in significant pain, and the nerve roots are not being pressured by the fracture site, then they may elect not to do anything but allow it to heal on its own (6-8 weeks).  Conversely, some literature has said that vertebroplasty should not be used for trauma induced fractures of the vertebra...In my opinion they are talking about sheer type fractures rather then compression fractures.  This needs top be clarified with the doctor considering the procedure.

The fact that she is in good health makes her a good candidate for vertebroplasty because she has less risk for complication.  But this may also be an indication for them not to perform the surgery because her healing capacity is likely very good.

Good luck Heather, hope you mom heals well whatever you choose.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net