Spinal compression fractures are a common health issue in elderly individuals. These fractures, usually caused by osteoporosis, can lead to severe back pain and a noticeable decline in quality of life. But does every spinal fracture require surgery? In this article, we will explore when surgery becomes necessary in elderly patients with compression fractures.

These fractures may occur even after minor trauma, such as a simple fall or sometimes even coughing. If not diagnosed or treated properly, they may lead to permanent spinal deformities and limited mobility. Early diagnosis and appropriate treatment are therefore essential.

What Is a Spinal Compression Fracture?

Spinal compression fractures occur when a vertebral body collapses and loses height, typically affecting the thoracic and lumbar spine. The most common cause is osteoporosis. In rare cases, trauma can also cause these fractures.

Who Is at Risk?

• Individuals over the age of 65
• Those diagnosed with osteoporosis
• Patients using corticosteroids
• People with a history of fractures
• Those with a sedentary lifestyle

What Are the Symptoms?

• Sudden onset of back or lower back pain
• Loss of height
• Kyphotic posture (hunched back)
• Pain that worsens with movement
• Numbness or weakness in the legs (rare)

When Is Surgery Considered?

Surgical intervention is not always necessary. However, it may be required in the following cases:

• Pain not improving after 2–3 weeks of conservative treatment
• Severe restriction in mobility and loss of independence
• Spinal canal narrowing with nerve compression
• Significant vertebral collapse and progressive deformity
• Multiple fractures or increasing kyphosis

Non-Surgical Treatment Options

• Short-term bed rest
• Pain medications (paracetamol, NSAIDs, or opioids if necessary)
• Use of lumbar support braces
• Osteoporosis treatment (vitamin D, calcium, bisphosphonates)
• Physical therapy and rehabilitation

Surgical Treatment Methods

Vertebroplasty:
Bone cement is injected into the fractured vertebra using a needle. The goal is to stabilize the vertebra and relieve pain.

Kyphoplasty:
Unlike vertebroplasty, a balloon is first inflated inside the vertebra, and then the cavity is filled with cement. This can partially restore the height of the vertebra.

Both procedures are minimally invasive and are usually performed under local anesthesia or light sedation.

Recovery and Post-Treatment Recommendations

• Most patients can walk within 1–2 days after the procedure.
• Basic needs like walking and using the bathroom can be resumed quickly.
• Osteoporosis treatment should be initiated and monitored long-term.
• Fall prevention measures should be taken at home (remove rugs, improve lighting, etc.).
• Strengthening and mobility exercises are highly recommended.

Spinal compression fractures in the elderly are most commonly caused by osteoporosis and significantly impact quality of life. Conservative treatment is the first step. However, in some cases, surgery may be necessary to relieve pain and improve mobility. With modern minimally invasive techniques, safe and effective results can be achieved.