Compression Fracture

What is it?

Compression Fracture of the vertebral body is a common condition and range from mild to severe. Fractures are usually caused by osteoporosis, especially in older adults. Small cracks in the vertebrae can occur and spread over time, leading to a complete vertebral fracture. If left untreated, the fractured vertebra can eventually collapse causing limited mobility, deformity, and pain.

These fractures are most common in the thoracic spine, typically as the result of osteoporosis. Over time, the vertebral discs dry out and lose strength while the bone of the vertebrae becomes porous and brittle. More severe osteoporosis can allow fractures to develop from even minor trauma.

Apart from osteoporosis, the other more common causes of compression fractures are metastatic tumor, multiple myeloma and vertebral hemangioma.

Symptoms

Common symptoms of a spinal compression fracture include:

  • Back pain that has a sudden onset. Pain may intensify when walking or standing and decrease when lying down.
  • Loss of height. After a number of compression fractures, the shape of the spine can change. Height loss can occur as the spine compresses and becomes shorter.
  • Kyphosis occurs when the back of the vertebra remains stable while the front portion erodes. This causes a wedge-like curvature of the spine leading to a stooped posture.

Diagnosis

Only about one-third of vertebral fractures are actually diagnosed, because many patients and families consider back pain symptoms as a normal part of aging. Therefore, compression fracture should be suspected in any patient older than 50 years with sudden onset of back pain, often without any history of increased force on the spine. Likelihood of developing this condition rises with an age, especially among women due to increased risk for osteoporosis. Approximately 25% of postmenopausal women are affected by spinal compression fractures.

Plain x-rays, CT scan or MRI, are often helpful in accurate diagnosis and prognosis.

Treatment

Traditional conservative treatment includes bed rest, pain medications, back brace, and physical therapy. If non-surgical treatment is ineffective or damage is more severe, spine surgery may be recommended. There are two main types of minimally invasive surgeries available, vertebroplasty, during which a needle containing acrylic bone cement is injected into the vertebra to stabilize fracture, and kyphoplasty, a procedure similar to vertebroplasty, which includes the use of a balloon to guide the cement and straighten the bone.

The sooner a fracture is repaired, the better the results. Vertebroplasty relieves pain in 80% of patients.