40% compression fracture of L1

40% compression fracture of L1

Q:

Age: 34 Sex: F Concern: compression fracture of vertebral

Dr. Tran,

I'm considering surgery and would like your opinion.

I broke my back and have a compression fracture of vertebral body L1 with ~40% anterior height loss. Transverse fracture line extends through the superior third of the verteral body with retropulsion (of bone relative to T12 present) of the superior third of 4mm. slight postural thoraco-lumbar dextro curvature. High T2/STIR signal present in vertebral body L1 extending into the pedicles bilaterally. Posterior ring intact.

I original saw an orthopaedic surgeon and later a neurosurgeon and both said that I'm the borderline case. Both of their first reaction was to do the surgery now (within the 2 weeks window) which will be a smaller operation and that it will reduce the chances of chornic pain and will correct the bone healing for sure. I can also wait and see how my injury heal but operations later will be more extensive since he will have to re-construct the bone. He said half of his patients chose to operate and the other half decided not to and it is my decision...

I'm in pain and have been taking percocet and valium continuously but it only help so much. I'm near the end of the 2 week window and need to make my decision in the next couple of days.

What is your thoughts? any suggestions to help me think make my decision?

Thank you for your help.

-- kc

A:

It is difficult to say. Without neurologic deficit, surgery is not absolutely required. What kind of surgery is your doctor proposing? You may want to ask them about kyphoplasty. You may not be a candidate for it due to the retropulsion. Sounds like you are in good hands. You would have to trust your physicians and balance all the available choices.
http://www.spine-health.com/dir/kyph.html

good luck

-- Sherman Nam Tran, M. D.

to ask Dr. Tran.