77 year old healthy man was assaulted and thrown to the ground resulting in severe upper back pain. Initial x-rays did not show a fracture or other abnormality. Because of persistent and disabling back pain, repeat spine radiographs were performed one week later and demonstrated partial collapse of the T5 (fifth thoracic) vertebra compatible with a traumatic compression fracture. Note the relative loss of height of the T5 vertebra (white arrows surrounding white dotted line) compared with the normal T6 vertebral (black dotted line).

Vertebroplasty was performed to palliate the patient’s pain. Under x-ray guidance, a local anesthetic agent and light sedation, small needles are passed through the skin over the patient’s back and into the broken vertebra. Bone cement (PMMA: poly-methyl-methacrylate) is carefully injected into the broken vertebral under fluoroscopic guidance. The procedure requires approximately 15 minutes and resulted in immediate pain relief for this patient. In appropriately selected patient groups, partial or complete pain relief can be achieved in 90% of this these patients.