Treating Spinal Fractures In Older Populations
Category: Spine | Author: Stefano Sinicropi
Our spine is generally strong and well-protected, but if it is subjected to too much acute trauma, one or more of the vertebrae that make up the spinal column can break. This is known as a spinal fracture, and they can be treated in a few different ways. When the problem develops in an older population, doctors need to consider some additional factors when determining the best route forward. In today’s blog, we explore how spinal fractures in older populations are typically treated.
Managing Geriatric Spinal Fractures
A recent study decided to take a closer look at spinal fracture rate, particularly among an aging population. For the study, they reviewed more than 600,000 spinal fractures since 2003. What they found was that spinal fracture rates were increasing in older populations, but only a specific type of spinal fracture was becoming more common.
The study took a closer look at two different types of spinal fractures – high-energy fractures and low-energy fractures. A high-energy fracture is something that occurs when the body is subjected to a significant trauma, like what you might experience during a car accident or a fall from a great height. Low-energy traumas still involve trauma to the spinal area, but much less force is involved. A slip and fall on the same level or tripping on the stairs are examples of a low-energy fracture cause.
Researchers uncovered that over the past few decades, the rate of high-energy spinal fractures remained relatively steady, but the same couldn’t be said for low-energy traumas. They found that the rate of low-energy spinal fractures had increased steadily in recent years. Researchers attributed this increase to the natural aging process, as the large group of Baby Boomers are now reaching their 60s and 70s.
We’ve also noticed an uptick in spinal fractures in older patients, and it’s something we work to treat on an individual basis. In younger populations that are more likely to be dealing with a high-energy spinal fracture, oftentimes conservative care can provide relief. Stabilizing and protecting the area while healing runs its course tends to provide great results. In older adults, additional factors need to be considered. Because their fracture was more likely to be low-energy in nature, and because there were likely some underlying individual factors that contributed to this low-energy fracture, like nature degeneration and the possibility of osteoarthritic degeneration, the doctor really needs to consider if conservative care is likely to restore stability that has only been further compromised by the fracture.
On the flip side of the coin, surgery isn’t always the best answer either. Older adults are more likely to have underlying health factors that can make surgery and the associated recovery a little riskier. Doctors need to balance the likely outcome with the inherent risks based on the patient’s individual health profile.
At the end of the day, there’s no one treatment path that is always correct for managing spinal fractures in older adults. If the provider believes that conservative care can restore strength, stability and function to the spinal column, or if surgery may be too risky, they may recommend a combination of non-operative treatments including:
- Short-term rest/Activity avoidance
- Physical therapy
- Anti-inflammatories/OTC pain medications
- Low-impact exercise
- Stretching therapy
- Heat/Cold packs
Should these treatments prove ineffective, or it’s clear that artificial stability enhancement is required, a minimally invasive corrective procedure may be pursued. The most common procedures are a vertebroplasty or kyphoplasty, in which bone cement is injected to provide further stability to the vertebrae as the fracture heals. Other tools may be used to restore height or vertebral alignment prior to the insertion of the bone cement. They can be very effective treatments, but they will be avoided if the surgeon believes similar results can be achieved with non-operative means.
Contact Dr. Sinicropi
For more information about geriatric spinal fractures, or for help with a different back issue, reach out to Dr. Sinicropi and the team at the Midwest Spine & Brain Institute today at (651) 430-3800.
