How Osteoporosis Creates Compression Fractures — and Why They Are Often Missed

A vertebral compression fracture occurs when the bony body of a vertebra — weakened by osteoporosis — collapses under the normal compressive load of body weight and posture. The fracture can be abrupt and painful, or it can develop gradually with worsening back pain over days to weeks. The typical patient is an older woman with postmenopausal osteoporosis, though men with long-term corticosteroid use, prostate cancer treatment histories, or metabolic bone disease are also at risk. The fracture most commonly occurs in the thoracic spine between T8 and T12, or at the thoracolumbar junction — the mechanical transition zone between the relatively rigid thoracic cage and the more mobile lumbar spine.

Pain is usually centered at the fracture level, worsens with standing and walking, and improves with lying down. Height loss and progressive kyphotic posture develop when multiple fractures have occurred over time. The reason these fractures are often missed in the early evaluation is that the pain pattern overlaps with muscle strain and lumbar degenerative disease. A plain radiograph or MRI that specifically evaluates for fracture is needed to identify the collapse. For patients within the Inspira network, a fracture identified on imaging ordered for back pain creates a clear referral pathway to our Mullica Hill spine team.

Kyphoplasty vs. Vertebroplasty: How They Differ and How We Choose

Both procedures are minimally invasive and involve introducing bone cement into the fractured vertebra under imaging guidance to stabilize it. The difference is in what happens before the cement is placed.
In vertebroplasty, bone cement is injected directly into the collapsed vertebra under fluoroscopic guidance to stabilize the fracture. The structural collapse that has already occurred is not reversed — the goal is pain relief through fracture stabilization.

In kyphoplasty, a balloon is first inflated inside the collapsed vertebra to create a cavity and restore some of the lost vertebral height before cement is injected into that cavity. The restoration of height, when it can be achieved, reduces the kyphotic deformity — the forward rounding — that compression fractures produce over time, and the cavity created by the balloon results in cement placement that is typically more contained and controlled.

We prefer kyphoplasty for most patients with acute or subacute fractures where height restoration is still possible. Vertebroplasty has a role in certain anatomical scenarios or when fracture chronicity limits height restoration potential. The decision is made based on MRI findings, fracture age, and the degree of vertebral body collapse, not on a blanket protocol.

Kyphoplasty Performed at Inspira Medical Center Mullica Hill

Kyphoplasty and vertebroplasty at our Mullica Hill location are performed at Inspira Medical Center Mullica Hill. The procedure is typically done under light sedation — general anesthesia is generally not required. Using live fluoroscopic imaging, the surgeon passes thin working cannulas into the fractured vertebra through small incisions in the skin. The balloon is inflated under precise pressure to restore height and create the bone cement cavity, then deflated and removed before cement is injected. The procedure takes approximately forty-five minutes to one hour per level treated. Most patients experience significant pain relief within twenty-four to forty-eight hours of the procedure and are mobile the same day. For patients already in the Inspira system, the familiarity of the facility and the coordination with Inspira medical staff — particularly for patients who are medically complex or on anticoagulation — is an advantage that matters practically. Importantly, kyphoplasty addresses the structural fracture and the pain it causes. It does not address the underlying osteoporosis that caused the fracture. Every patient who undergoes kyphoplasty at our Mullica Hill office receives a specific recommendation to address bone density with their primary care physician or an Inspira-affiliated endocrinologist or rheumatologist. Treating the fracture without addressing the bone quality that produced it leaves the remaining vertebrae at ongoing risk.

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Your Surgical Team at POA Mullica Hill

Rahul V. Shah

Dr. Rahul V. Shah, MD, FAAOS

Board-Certified Orthopaedic Spine Surgeon  |  Fellowship-Trained, UCSF  |  Chief Resident, Yale

Dr. Shah's precision with kyphoplasty is in the imaging interpretation and the technical execution. Determining whether a fracture is acute or chronic — and whether height restoration is still mechanically possible — requires careful MRI analysis of signal patterns in the collapsed vertebra. His UCSF training emphasized evidence-based decision-making: patient selection, fracture timing, and imaging-guided technique all determine whether kyphoplasty produces the outcome the patient is hoping for. Mullica Hill patients benefit from that analytical rigor applied to a procedure that, while minimally invasive, has real implications for vertebral body mechanics and adjacent segment loading.

  • FAAOS — Fellow, American Academy of Orthopaedic Surgeons
  • Spine Surgery Fellowship — University of California, San Francisco
  • Chief Resident — Yale University Orthopaedic Surgery
  • Faculty — Rowan University Medical School

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Joseph R. Zerbo male in white lab coat

Dr. Joseph R. Zerbo, DO

Board-Certified Orthopaedic Spine Surgeon  |  NASS Member  |  35+ Years in Southern NJ

Dr. Zerbo brings a distinctly whole-person lens to osteoporotic compression fractures. These fractures do not exist in isolation — they are the consequence of bone that has progressively weakened, and they are often the beginning of a cascade of further fractures if bone density is not addressed. His D.O. background informs a treatment approach that connects the fracture to the systemic picture: he routinely discusses bone density evaluation and treatment with patients and their Inspira primary care providers as part of the fracture care plan. The kyphoplasty stabilizes the fracture; the broader care plan is about preventing the next one.

  • AOBOS Board-Certified — American Osteopathic Board of Orthopaedic Surgeons
  • NASS Member — North American Spine Society (since 1999)
  • Chief Resident — Kennedy Memorial Hospital / UMDNJ
  • Founder — Zerbo Spine, PA

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Kyphoplasty & Vertebroplasty FAQs

My Inspira doctor found a compression fracture on imaging — what happens next?

Is kyphoplasty done at the Inspira campus?

How quickly does pain improve after kyphoplasty?

Does kyphoplasty fix osteoporosis?

Will I lose height permanently from a compression fracture?

My Inspira doctor found a compression fracture on imaging — what happens next?

We begin with a spine-specific evaluation to confirm the fracture, determine its age and severity, and assess whether you are a candidate for kyphoplasty. We review your MRI for signs of fracture acuity, measure the degree of vertebral height loss, and assess whether height restoration is still possible. If kyphoplasty is appropriate, we can schedule the procedure at Inspira Medical Center Mullica Hill and coordinate pre-procedural clearance with your Inspira primary care team.

Is kyphoplasty done at the Inspira campus?

Yes. Kyphoplasty and vertebroplasty procedures at our Mullica Hill location are performed at Inspira Medical Center Mullica Hill. For patients who are already part of the Inspira Health Network, this means your procedure is performed in a facility connected to your existing medical records, and your Inspira providers can follow your recovery within the same system.

How quickly does pain improve after kyphoplasty?

Most patients experience meaningful pain relief within twenty-four to forty-eight hours. The compression fracture, which was the source of significant positional pain — pain that worsened with standing and walking and improved with lying down — is stabilized, and the pain pattern typically improves dramatically. Some patients are largely pain-free within a day of the procedure; others improve over the first one to two weeks as soft tissue healing continues.

Does kyphoplasty fix osteoporosis?

No — and this is an important distinction. Kyphoplasty stabilizes the fractured vertebra and addresses the pain it is causing, but the underlying bone density that allowed the fracture to occur remains unchanged. Every patient who undergoes kyphoplasty should be evaluated for osteoporosis treatment. We coordinate that recommendation with your Inspira primary care physician or appropriate specialist to ensure the underlying bone quality problem is addressed and future fractures are prevented.

Will I lose height permanently from a compression fracture?

Some height loss may be permanent, particularly if the fracture has been present for weeks or months before kyphoplasty is performed — the vertebra may have consolidated in a collapsed position. Kyphoplasty is most effective at restoring height when performed within the first six to eight weeks of the fracture, while the bone is still mobile enough to respond to the balloon inflation. This is one reason that early evaluation is valuable: the window for height restoration closes as the fracture heals in a collapsed configuration.

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