Vertebral Compression Fractures


 

What is a vertebral compression fracture?

A vertebral compression fracture is a result of collapse of the vertebral body resulting in loss of height when the load on a vertebra exceeds its stability or inherent strength. The most common cause of vertebral compression fractures is trauma and underlying osteoporosis. Vertebral compression fractures are fairly common in elderly females with osteoporosis. The traumatic event may be mild. Common traumatic events include falls in the elderly. Vertebral compression fractures may also be a result of a tumor invading the vertebra thereby making it weaker.  

How is a vertebral compression fracture diagnosed?

A vertebral compression fracture will typically produce localized back pain after a traumatic event. The pain is typically sharp and stabbing and usually worsened with twisting and bending movements of the back. The pain radiates from the central back area towards the sides of the spine. There is usually localized tenderness at the site of the fracture. Compression fractures rarely cause compression of the spinal cord or nerve roots. Xray study will usually reveal loss of height of the vertebra. A CAT scan will show the compressed vertebra. The MRI is usually the best study to evaluate a compression fracture because it can determine if the fracture is acute (recent or active) by showing signs of inflammation in the bone.

What is the treatment for a vertebral compression fracture?

If the pain is mild and tolerable, the fracture can be treated nonsurgically. Pain medications such as  Tylenol, anti-inflammatories, and muscle relaxants are commonly prescribed. A back brace is helpful to stabilize the spine and relieve the tension on the fractured vertebra. Physical therapy is recommended to reduce muscle tension and spasms, improve range of motion, and strengthen the core muscles.

A procedure known as kyphoplasty is effective for more severe pain from a vertebral compression fracture. It is a minimally invasive technique whereby a special cement mixture known as methylmethacrylate is inserted into the vertebral body. The cement hardens inside the vertebral body in several minutes and stabilizes the fracture and reduces pain.  

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