Surgery for lumbar compression fracture

Surgical intervention is required when neurologic dysfunction and/or instability occurs as a result of the lumbar fracture.
Neurologic problems may manifest in many ways. Reduced leg strength (paresis) or complete weakness (paralysis) is an obvious problem. Loss of sensation in the lower extremities and in the perianal area (saddle anesthesia) can be just as important. Urinary retention and urinary and fecal incontinence are very important signs that indicate the need for emergency surgery.
Vertebroplasty has been available for many years. This procedure involves injecting a form of cement polymer into the fractured vertebral body. The vertebral body then has better resistance to physiologic loads when the patient is upright, thus decreasing the amount of pain associated with the fracture. The procedure may be performed with the patient under local or general anesthesia. A percutaneous trocar or large needle is introduced into the fractured body through the pedicle, and the cement is injected. Fluoroscopy is used to guide the surgeon for correct localization.