The C6-C7 spinal segment—located towards the bottom of the cervical spine—helps provide the neck with structural support, some flexibility, and does its part to protect the spinal cord.
It’s also the location where the C7 nerve root branches off from the spinal cord and travels down the arm to enable:
- Straightening the elbow, lifting the wrist, elongating fingers to a stretched out position
- Movement to the triceps muscle in the back of the upper arm
- Sensation from the neck down to the palmside of the forearm and into the palm and middle finger of the hand.
The C6-C7 level has an elevated risk for becoming a source of pain due to the fact that this level of the cervical spine is quite mobile.
A broken vertebra at the C6-C7 level can cause pain and other symptoms, especially if the adjacent nerve root is affected.
Typically, the first line of treatment for vertebral compression fractures is conservative therapy (non-surgical), which includes pain medication, calcium and vitamin D supplements, rest (but only for a short time period, as prolonged inactivity can lead to further bone loss), and external bracing.
Pain from a spinal fracture can last for several months while healing, but if it heals well with conservative treatment, the pain will usually improve significantly within a few days or weeks.
When pain from a compression fracture persists, surgery may be considered to repair the fracture. The two commonly used procedures for spine fractures from osteoporosis are vertebroplasty and kyphoplasty, but in rare instances, where the patient has significant loss of vertebral height, spine fusion surgery may be appropriate.
- Vertebroplasty and kyphoplasty are types of Vertebral Augmentation for Compression Fractures.
Both vertebroplasty and kyphoplasty have been shown to decrease or eliminate the pain associated with vertebral compression fractures. Medicare and most private insurance companies cover both procedures.
Patients best suited for vertebroplasty are those with a painful, non-healing vertebral compression fracture, regardless of the age of the fracture (although the procedure is most successful for more recent fractures). Most patients experience these fractures due to underlying osteoporosis, but patients who suffer fractures due to tumors may also be eligible.
Patients not considered for vertebroplasty include those who are having pain not related to a vertebral compression fracture, those who have an extensive fracture affecting surrounding structures, or who suffer from an infection in which case the infection would have to be adequately treated first prior to undergoing vertebroplasty.
The goals of the vertebroplasty surgical procedure are to stabilize the spinal fracture and to stop the pain caused by the fracture. Vertebroplasty is considered a minimally invasive surgical procedure because the procedure is done through a small puncture in the patient's skin (as opposed to an open incision). A typical vertebroplasty procedure, described below, usually takes about 1 hour to complete.
The patient is treated with local anesthesia and light sedation, usually in an x-ray suite or operating room on an outpatient basis.
- A biopsy needle is guided into the fractured vertebra under X-ray guidance through a small puncture in the patient's skin.
- Specially formulated acrylic bone cement is injected under pressure directly into the fractured vertebra, filling the spaces within the bone - with the goal of creating a type of internal cast (a cast within the vertebra) to stabilize the vertebral bone.
- The needle is removed and the cement hardens quickly (about 10 minutes), congealing the fragments of the fractured vertebra and stabilizing the bone.
- The small skin puncture is covered with a bandage.
Shortly after the cement has hardened, the patient is free to leave the medical facility and can go home the same day. Patients are usually advised not to drive themselves home the day of the procedure, and may need to spend the night at a hotel in the area if they have to travel a long distance. If the patient needs further observation after the procedure, is particularly frail, or will not have assistance at home, a short stay in the hospital may be recommended.
The goals of a kyphoplasty surgical procedure are designed to stop the pain caused by a spinal fracture, to stabilize the bone, and to restore some or all of the lost vertebral body height due to the compression fracture.
Kyphoplasty is a type of Vertebral Augmentation for Compression Fractures
Performing Kyphoplasty Surgery
During kyphoplasty surgery, a small incision is made in the back through which the doctor places a narrow tube. Using fluoroscopy to guide it to the correct position, the tube creates a path through the back into the fractured area through the pedicle of the involved vertebrae.
- Using X-ray images, the doctor inserts a special balloon through the tube and into the vertebrae, then gently and carefully inflates it. As the balloon inflates, it elevates the fracture, returning the pieces to a more normal position. It also compacts the soft inner bone to create a cavity inside the vertebrae.
- The balloon is removed and the doctor uses specially designed instruments under low pressure to fill the cavity with a cement-like material called polymethylmethacrylate (PMMA). After being injected, the pasty material hardens quickly, stabilizing the bone.
Kyphoplasty surgery to treat a fracture from osteoporosis is performed at a hospital under local or general anesthesia. Other logistics for a typical kyphoplasty procedure are:
- The kyphoplasty procedure takes about one hour for each vertebra involved
- Patients will be observed closely in the recovery room immediately following the kyphoplasty procedure
- Patients may spend one day in the hospital after the kyphoplasty procedure
Patients should not drive until they are given approval by their doctor. If they are released the day of the kyphoplasty surgery, they will need to arrange for transportation home from the hospital.
If you'd like to discuss this condition with one of our doctors, we would be more than happy to contact you. You don't need a primary care physician referral for us to see you.
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