Vertebral Augmentation for Spinal Compression Fractures in Flint, Michigan
Vertebral augmentation is a minimally invasive, image-guided procedure that stabilises a collapsed spinal bone using surgical cement, through a needle rather than an open incision. The two forms are vertebroplasty and balloon kyphoplasty. Because it is done through a needle under live X-ray, it is often possible for patients who are considered too frail or too high-risk for open spinal surgery. At the Institute of General and Endovascular Neurosurgery (IGEN) in Flint, these procedures are performed by Dr. Shah-Naz Khan, MD, FRCSC, FAANS, a fellowship-trained neurosurgeon with formal neuroendovascular training.
What it treats
A vertebra that has collapsed and stayed painful, from osteoporosis, trauma, or tumour.
How it is done
Through a needle under live X-ray guidance. No open incision, usually same-day.
Who it can help
Including patients turned down for open surgery because of age or general health.
Honest candidacy
Not every fracture needs it. Many heal on their own. We will tell you if yours will.
What a spinal compression fracture actually is
A vertebral compression fracture happens when one of the building-block bones of the spine loses height and collapses, usually at the front. In older adults the most common cause is osteoporosis, where bone has thinned enough that an ordinary movement, a minor fall, or even a cough can be sufficient. It can also follow significant trauma, or occur where a tumour has weakened the bone.
Here is the honest starting point. Many compression fractures settle on their own. With time, pain relief, activity as tolerated, and treatment of the underlying osteoporosis, a good number of patients improve over a few weeks without any procedure. Conservative care is a legitimate first path and it is the right answer for a lot of people.
The problem is the group where that does not happen. When pain stays severe, when it keeps someone in bed or in a chair, when the vertebra continues to lose height, or when the fracture is unstable, the situation changes. Prolonged immobility in an older adult carries its own risks: pneumonia, blood clots, muscle loss, pressure injuries, and further bone loss from inactivity. That is the point at which stabilising the bone becomes worth serious discussion.
Vertebral augmentation exists for that group. It is not a treatment for back pain in general, and it is not a substitute for treating osteoporosis. It is a targeted way to stabilise a specific fractured vertebra that is not settling.
If you are still working out where your pain is coming from, our pages on degenerative spine conditions and spinal stenosis cover the other common causes.
Augmentation vs conservative care
Why a spinal compression fracture is treated as a serious event, not just a sore back
A vertebral compression fracture in an older adult is a marker of frailty, and outcomes after one are worse than most patients expect. The largest analysis available, covering just over two million United States Medicare patients, found the following.
85.1%
Ten-year risk of death after a vertebral compression fracture across the whole cohort. This is a Medicare population, so almost entirely aged 65 and over, and a large share of that figure reflects the ordinary risks of age rather than the fracture itself.
Ong et al., Osteoporosis International 2018. Reference 1
19% lower
Adjusted ten-year mortality risk in patients treated with balloon kyphoplasty compared with those managed without a procedure. For vertebroplasty the figure was 7% lower. Same cohort, same analysis.
Ong et al., Osteoporosis International 2018. Reference 1
0.78
Pooled hazard ratio for death, augmentation versus non-surgical management, in a separate systematic review and meta-analysis of more than two million patients. Roughly a 22% lower likelihood of death out to ten years.
Hinde et al., Radiology 2020. Reference 2
How to read those numbers honestly
These are observational findings, not a randomised trial. They show a strong and repeatedly reproduced association between vertebral augmentation and survival. They do not on their own prove the procedure causes the difference. Patients who are selected for a procedure may differ from those who are not, in ways the statistics cannot fully correct for. Two independent research groups using different methods reached the same conclusion, which is what makes the finding worth taking seriously, but association is not proof.
There is also evidence pointing the other way, and you should know about it. A 2018 Cochrane review of sham-controlled trials concluded that vertebroplasty offered no important benefit over a placebo procedure for pain, disability, or quality of life. Reference 3
Both findings can be true, because they answer different questions. The sham trials measured pain, over weeks to months, in carefully selected trial participants. The mortality data measured survival, over two to ten years, across an entire national population. A procedure can look unimpressive on a short-term pain score and still sit alongside better long-term survival, most plausibly because getting someone upright and moving again avoids the cascade that follows prolonged bed rest.
Dr. Khan will tell you which body of evidence actually applies to your situation, and will say so plainly if she thinks a procedure is unlikely to help you.
Vertebroplasty and balloon kyphoplasty
Both stabilise a fractured vertebra with bone cement, delivered through a needle under live X-ray guidance. The difference is whether a balloon is used first to create a cavity and attempt to restore some of the lost height.
Vertebroplasty
A thin needle is guided into the fractured vertebra under live X-ray. Surgical bone cement is injected directly into the bone, where it hardens and internally splints the fracture. There is no attempt to restore the lost height of the vertebra.
Balloon kyphoplasty
The same needle access is used, but a small balloon is inflated inside the vertebra first. This creates a cavity and can lift some of the collapsed bone back toward its original height. The balloon is removed and cement is placed into the cavity it created.
Which one is right for you is a clinical decision, not a preference. It depends on how recent the fracture is, how much height has been lost, the shape of the collapse on your imaging, and your bone quality. Dr. Khan will explain which she is recommending in your case and why. Book a consultation to have that conversation.
Am I a candidate for vertebral augmentation?
Candidacy is decided on your imaging and your story together. A fracture on a scan is not on its own a reason to treat.
Often considered when
- Severe back pain that has not settled with conservative care
- Pain that clearly matches the level of the fracture on imaging
- The fracture is still active on MRI, showing marrow oedema rather than an old healed injury
- Pain is keeping you in bed or a chair, with the complications that brings
- The vertebra is continuing to lose height on repeat imaging
- Open surgery has been ruled out because of age, frailty, or other medical conditions
Usually not the right answer when
- The fracture is old, healed, and no longer the source of pain
- Your pain is coming from something else, such as stenosis or a disc
- Symptoms are improving steadily on conservative care already
- There is bone pressing on the spinal cord or nerves, which usually needs a different operation
- There is active infection, or a bleeding problem that cannot be corrected
- The fracture pattern is unstable and needs instrumented stabilisation instead
Being told you are not a surgical candidate is not the same as being told nothing can be done. A significant part of why vertebral augmentation exists is that it can often be offered to patients whose age, heart or lung disease, or general frailty rules out open spinal surgery. If you have been told open surgery is too risky for you, that is a reason to ask about augmentation, not a reason to stop asking.
From first appointment to going home
Your consultation is at 1187 W Bristol Rd, Suite 1, Flint, MI 48507, with Dr. Shah-Naz Khan.
Assessment and imaging
Your history, an examination, and a review of your scans. An MRI is often needed to confirm the fracture is recent and active, since that is what predicts whether treating it will help.
The decision
Dr. Khan explains whether augmentation is indicated, which type she recommends, and what conservative care would look like instead. If she does not think it will help you, she will say so.
The procedure
Performed under live X-ray guidance, usually with local anaesthetic and sedation. Needle access only. Most cases take well under an hour per level treated.
Recovery and after
Many patients go home the same day or after one night, and are encouraged to get moving early. The underlying osteoporosis is then addressed, because that is what prevents the next fracture.
Treating the fracture is only half the job. Once you have had one osteoporotic vertebral fracture, your risk of another is higher. Bone density assessment, medical treatment for osteoporosis, vitamin D and calcium status, and falls prevention are all part of the plan. Stabilising one bone while leaving the underlying condition untreated is not a complete answer, and we will not treat it as one.
What are the risks of vertebral augmentation?
It is a low-risk procedure in experienced hands, but it is not a no-risk procedure, and you are entitled to the full picture before you consent.
Cement leakage
Cement can escape beyond the vertebral body. Most leaks cause no symptoms at all, but a leak toward the spinal canal or into a vein is the complication that matters. Live X-ray guidance throughout the injection is how this is minimised.
Fracture at an adjacent level
A new fracture can occur at a neighbouring vertebra. Whether the procedure itself contributes, or whether it simply reflects already fragile bone, is still debated. Treating the underlying osteoporosis is the main defence either way.
The general risks
Infection, bleeding, nerve irritation, and the risks of sedation or anaesthesia, as with any procedure. Your individual risk depends on your health and will be discussed specifically with you rather than in generalities.
Image-guided spine work, done by a neuroendovascular-trained surgeon
Shah-Naz Khan, MD, FRCSC, FAANS is a board-certified, fellowship-trained neurosurgeon and the founder of the Institute of General and Endovascular Neurosurgery in Flint. She is a Clinical Assistant Professor in the Department of Surgery at Michigan State University, College of Human Medicine.
Vertebral augmentation sits at the meeting point of two skill sets: spinal anatomy, and working accurately inside the body under live imaging through a needle. The second of those is the core of neuroendovascular practice, where catheters and instruments are navigated through vessels under continuous fluoroscopy. It is the same discipline of hand, eye, and image that a cement injection into a fractured vertebra demands, and Dr. Khan is formally trained in it.
She reviews every case personally, and she is direct about what a procedure can and cannot achieve. If your fracture is likely to settle on its own, or if your pain is coming from somewhere else entirely, you will be told that rather than offered a procedure.
Second opinions are welcome, including opinion-only consultations where you simply want an independent read on whether a recommended procedure is the right one. You can also read more about her minimally invasive and endovascular practice.
Credentials
- MD, board-certified neurosurgeon
- FRCSC, Royal College of Physicians and Surgeons of Canada
- FAANS, American Association of Neurological Surgeons
- Fellowship-trained in neuroendovascular technique
- Clinical Assistant Professor, Michigan State University
- Published author, Springer academic press
Fast-track a compression fracture assessment
Referrals are triaged by pain severity, functional loss, neurological findings, and imaging. An MRI showing marrow oedema at the level in question is the most useful single study for determining whether augmentation is likely to help, and we are happy to advise on imaging before referral if that is easier.
Patients previously declined for open spinal surgery on the grounds of frailty or comorbidity are specifically worth referring, since needle-based stabilisation is frequently still an option for them. Findings, options, and next steps are documented clearly back to you, with support for co-management.
Vertebral augmentation: frequently asked questions
What is vertebral augmentation?
Is vertebral augmentation available near me in Flint?
Does a spinal compression fracture really affect life expectancy?
What is the difference between vertebroplasty and kyphoplasty?
I was told I am too high-risk for spine surgery. Can I still have this?
Is there research saying vertebroplasty does not work?
How long does recovery take after vertebral augmentation?
What are the risks of vertebral augmentation?
Will my insurance cover vertebral augmentation?
Do I need a referral to be seen for a spinal compression fracture?
References
Every statistic on this page is drawn from the peer-reviewed sources below and was verified against the primary publications in August 2026. This page is general education about a procedure and is not medical advice about your individual condition.
- Ong KL, Beall DP, Frohbergh M, Lau E, Hirsch JA. Were VCF patients at higher risk of mortality following the 2009 publication of the vertebroplasty "sham" trials? Osteoporosis International. 2018;29(2):375-383. doi:10.1007/s00198-017-4281-z
- Hinde K, Maingard J, Hirsch JA, Phan K, Asadi H, Chandra RV. Mortality outcomes of vertebral augmentation (vertebroplasty and/or balloon kyphoplasty) for osteoporotic vertebral compression fractures: a systematic review and meta-analysis. Radiology. 2020;295(1):96-103. doi:10.1148/radiol.2020191294
- Buchbinder R, Johnston RV, Rischin KJ, et al. Percutaneous vertebroplasty for osteoporotic vertebral compression fracture. Cochrane Database of Systematic Reviews. 2018;11:CD006349. doi:10.1002/14651858.CD006349.pub4
Still in pain weeks after a spinal fracture?
Bring your story and your scans. Dr. Khan will review them personally and give you a straight answer about whether stabilising the fracture would help you, or whether your pain is coming from something else that needs a different plan.
- Call or send the contact form. No referral yet? Reach out anyway and the team will advise your next step.
- Bring any existing X-rays, CT, or MRI images and reports, and a list of your medications.
- Been told open surgery is too risky for you? Say so when you call. It is exactly the situation this procedure was designed for.