Vertebral Compression Fractures & Kyphoplasty NYC | Dr. Zeeshan Sardar

Vertebral Compression Fractures & Kyphoplasty in New York City

Dr. Zeeshan Sardar, MD, MSc, F.R.C.S.C
Director, Quality & Patient Safety (QPS) – Och Spine Hospital
Medical Director, Spine Unit – Och Spine Hospital
Co-Chief of Spinal Deformity Surgery • NewYork-Presbyterian / Columbia University
Och Spine Hospital • New York, NY

Vertebral compression fractures are the most common fractures in patients with osteoporosis — more common than hip fractures and wrist fractures combined. They occur when a vertebral body collapses under load it can no longer support due to weakened bone. The result is sudden, severe mid-back or lower back pain, often without a clear traumatic event. Many patients describe waking up with severe pain, or developing it after a minor movement like sneezing or picking something up from the floor. For patients with acute, painful vertebral compression fractures that do not respond to conservative management, kyphoplasty is a safe and effective minimally invasive treatment that stabilizes the fracture, reduces pain, and can restore some vertebral height.

WHAT IS A VERTEBRAL COMPRESSION FRACTURE?

The vertebral body — the large, block-shaped front portion of each vertebra — is the primary load-bearing structure of the spine. In osteoporotic bone, the trabecular architecture that provides internal support is significantly reduced. Under the loads of normal daily activity, the weakened vertebral body can fracture, compressing from its normal height into a wedge or collapsed shape. Most compression fractures occur in the thoracic spine (particularly T7–T12) and the thoracolumbar junction (T12–L2). Multiple compression fractures in the thoracic spine produce progressive kyphosis — the forward rounding that eventually leads to the characteristic stooped posture of advanced osteoporosis.

SYMPTOMS

  • Sudden, severe back pain — often mid-back or lower back, sometimes radiating to the sides
  • Pain that is worse with standing, walking, or moving and better with lying down
  • Progressive loss of height
  • Progressive kyphotic (forward-bending) posture
  • Reduced activity tolerance and functional decline

DIAGNOSIS

X-rays confirm vertebral height loss and the wedge-shaped compression deformity. MRI is the most informative study — it distinguishes acute fractures (which show bone marrow edema and are potentially painful and unstable) from old, healed fractures (which do not). This distinction is critical in deciding which fractures are likely to respond to kyphoplasty. CT provides bony detail and assesses posterior vertebral wall integrity, which is important for safe procedural planning.

NON-SURGICAL TREATMENT

Acute vertebral compression fractures are initially managed conservatively in many patients: relative rest and activity modification; analgesic medications; bracing with a thoracolumbar orthosis (TLSO) to reduce loading during healing; and initiation or optimization of osteoporosis therapy to prevent further fractures. Many compression fractures heal with conservative care over 6–12 weeks, though some persistent height loss and deformity typically remain.

KYPHOPLASTY

Kyphoplasty is a minimally invasive procedure for acute, painful vertebral compression fractures not responding adequately to conservative management. It involves placement of small working cannulas through the pedicles of the fractured vertebra under fluoroscopic guidance; inflation of a small balloon inside the vertebral body to create a cavity and restore some vertebral height; removal of the balloon; and injection of bone cement (polymethylmethacrylate) into the cavity to stabilize the fracture. The procedure is performed under sedation or general anesthesia as an outpatient or overnight procedure. Most patients experience significant pain relief within 24–48 hours. The cement stabilizes the fracture and allows immediate return to gentle activity.

WHEN IS KYPHOPLASTY MOST APPROPRIATE?

  • Acute osteoporotic compression fracture confirmed to be active on MRI (bone marrow edema present)
  • Significant pain not responding to 4–6 weeks of conservative management
  • Intact posterior vertebral wall
  • No evidence of infection or tumor as the cause of the fracture

WHY CHOOSE DR. SARDAR

Dr. Sardar treats the full spectrum of osteoporotic spine disease, from vertebral compression fractures managed with kyphoplasty to progressive kyphotic deformity requiring surgical correction. He works within a multidisciplinary framework that includes metabolic bone specialists to ensure that every patient with a compression fracture receives appropriate osteoporosis treatment to prevent future fractures.

This page is for educational purposes only and does not constitute individualized medical advice.

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