Our spine is made up of 33 vertebrae or spinal bones having a complex structure. Out of these 33 vertebrae, 7 vertebrae are in the cervical region, 12 in the thoracic region, 5 each in the lumbar and sacral region and 4 in the coccyx bone. Spinal bones or vertebrae in the sacrum and coccyx are fused together, whereas elsewhere these are individually separated from each other. Spine or the back bone in human beings provides the strength to maintain an erect structure. Human beings are the only species in animal kingdom that stands erect on two feet and hence the spinal column is so designed to maintain this configuration. Normally our spine is an ‘S’ shaped structure with two primary and two secondary curves to attain an erect posture.
Because of trauma (injury) or weak bones as in osteoporosis, the spinal bones or vertebrae can fracture and collapse, resulting in increase in curvature of the spine. The collapse can vary from mild to moderate to severe and in extreme cases can lead to injury or compression of the spinal cord with permanent damage to the neural structures and thereby permanent loss of functions in the body.
Earlier the treatment of such cases was conservative with pronged rest leading to further weakening of bones (osteoporosis). Prolonged rest also leads to many hazards like increased risk of clot formation, thromboembolic sequelae, worsening of hypertension and diabetes, risk of bed sores and poor cardiorespiratory reserves etc.
Latest research guidelines advocate immediate stabilization of the fractured bony segments and early mobilization. This can be safely achieved by introducing bone cement (PMMA) into the body of the vertebra through a thin pipe of the size of a thick needle under local anesthesia only. This procedure is done precisely under X-ray guidance in a fully equipped operation theatre.
The cement solidifies in 10 minutes and the fractured bone stabilizes immediately with very good long term results. In cases where the vertebral height decreases more than 50%, the bone height is established by first inflating it with a balloon and then injecting the cement.