Vertebral Compression Fractures
Vertebral Compression Fractures almost always occur in the thoracic (upper back) and lumbar (lower back) segments of the spine. Vertebrae are the bones that form the spinal column. The most common cause of a vertebral fracture is osteoporosis, due to the weakened bone state of spinal vertebra.
A typical vertebral compression fractures is called a wedge fracture. Normally, the fracture will occur in the front end of the vertebra, causing it to collapse, leaving the back end of the bone in the same position, creating a wedge-shaped vertebra. There are also crush and burst fractures that can occur. A crush fracture is exactly what it sounds like; the entire vertebra is broken, rather than just the front end. A burst fracture involves loss of bone in both the front and back ends of the vertebra, causing it to be unstable.
Who’s at risk for Vertebral Compression Fractures?
There are two groups of people who are at high risk for vertebral compression fractures: people with osteoporosis and those with cancer that has spread to their bones. The danger with osteoporosis is many patients do not know that they have the bone weakening disease and cannot take steps to prevent a compression fracture. Women over the age of 50, who are going through menopause, or have in the past, are at the highest risk to develop osteoporosis. Some types of cancer, such as lymphoma, can decrease the strength of the bones. These patients should be monitored for spinal fractures.
An initial symptom of a vertebral fracture is sharp pain that eventually can become chronic. Standing up will typically make the pain worse, while lying down will cause the pain to subside. These small fractures can ultimately have permanent effects. The damaged vertebra can cause height loss and a loss of strength in the spine. With wedge fractures, since the back part of the bone is unchanged and the front end collapses, the spine can curve, creating a hunched posture called kyphosis, or dowager’s hump. Because of the stability of a vertebral fracture, there is not normally any damage to the spinal cord.
One of the biggest issues with a vertebral compression fracture is that they are not treated properly. A lot of patients just account their back pain as the result of older age, or as a muscle strain, and don’t seek proper medical treatment.
When diagnosing a vertebral compression fracture, it is important to diagnose the correct cause of the back pain to take the proper steps in treatment. Patients should discuss their medical history and condition in depth with an Orthopaedic Physician . This can include discussing the intensity of the pain, signs of osteoporosis, and other indications that could have lead to a compression fracture. A physical examination of the spine to test areas for sensitivity in certain vertebrae should be performed. An X-ray can be done to confirm the diagnosis.
Nonsurgical treatment methods include rest, heat and ice, and medications to relieve the pain. If the fracture is severe, there are two main surgical options: Vertebroplasty and Kyphoplasty. A Vertebroplasty involves injecting cement into the fractured vertebrae under high pressure. This stabilizes the spine and allows it to support the body again. A Kyphoplasty is similar, but instead, a balloon is inserted into the collapsed disc to restore the height and shape of the vertebrae. Cement is injected to hold the balloon in place and support the spine. Both of these procedures are performed as outpatient and can be done right in the OSC office.
There is a higher risk for multiple compression fractures after a patient has sustained one. Some prevention methods include calcium and vitamin D supplements and weight-bearing exercises to strengthen the bones, especially for those with osteoporosis.
It is important to receive a correct diagnosis when a spinal fracture occurs. Do not hesitate to schedule an examination if you have consistent back pain. It could be more serious than you think!