For osteoporotic vertebral compression fractures of the spine, is surgery or conservative treatment better?

Planner: Chinese Medical Association

Reviewer: Han Liqiang, deputy chief physician, Tianjin Third Central Hospital

Osteoporotic vertebral compression fractures of the spine mainly occur in the elderly. Due to osteoporosis, bone density decreases, making the vertebrae of the spine fragile and prone to compression fractures with slight or no obvious external force. The treatment methods are mainly conservative treatment and surgical treatment.

Conservative treatment means absolute bed rest, avoiding spinal activities, and supplemented with analgesics, fracture healing and anticoagulant drugs. Bed rest usually takes 6 to 8 weeks, after which you can wear a brace to start walking. Surgical treatment generally uses percutaneous balloon vertebroplasty, which is to inject bone cement into the fractured vertebral body to strengthen the vertebral body and quickly relieve pain. Generally, you can wear a brace to walk 24 hours after surgery. The disadvantage of conservative treatment is that the bed rest time is long, and related complications may occur during bed rest, such as pressure sores, urinary tract infections, aspiration pneumonia, lower extremity venous thrombosis, etc., and severe cases may die from complications. Therefore, doctors generally recommend that patients with surgical indications undergo surgical treatment to effectively relieve pain, get out of bed and resume normal life as soon as possible, and minimize the occurrence of bed rest complications. Of course, whether surgical treatment can be adopted requires the doctor to make a systematic assessment of the patient (such as whether the patient can tolerate surgery and other basic physical conditions, various examination indicators, etc.) and then decide.