Vertebral Compression Fracture: Complications, Symptoms, Diagnosis, and Treatment
A compression fracture is a type of bone fracture that occurs when one or more vertebrae in the spine collapse or become compressed. It commonly happens in the lower back or mid-back regions and can cause significant pain and discomfort, as well as decreased mobility.
What is a Compression Fracture?
Vertebral compression fractures are collapses in the spine caused by osteoporosis, trauma/injury, and diseases that affect bone strength. Trauma or injury causing a vertebral compression fracture can occur with a fall from a high height (falling from a tree, landing hard when skydiving) in which the person puts a hard impact on the spine when landing on their feet or buttocks. People with certain medical conditions, such as multiple myeloma or cancer that has spread to the spine, may also be at a higher risk of developing compression fractures.
It can also occur during a car accident. Osteoporosis, cancer, and Paget’s Disease are examples of conditions that also weaken the spine and leave a patient more vulnerable to a compression fracture. Often lower back is the complaint but it can also occur in the mid, upper back or neck and the pain may radiate to the hip, abdomen, or thigh pain. Numbness, tingling, and weakness may also be present.
Symptoms of a compression fracture can include back pain, decreased height, and a hunched posture. Some people may also experience numbness or tingling in their limbs or difficulty walking. Treatment options for compression fractures depend on the severity of the fracture and the underlying cause but can include pain management, rest, and physical therapy. In severe cases, surgery may be necessary to stabilize the spine and prevent further damage.
If you suspect you may have a compression fracture, it's important to seek medical attention right away. An early diagnosis and appropriate treatment can help alleviate pain and prevent further complications.
Vertebral Compression Fracture Symptoms
Vertebral compression fractures occur when the bones in the spine, known as vertebrae, become compressed or collapse. This can cause a range of symptoms, including pain and decreased mobility. The symptoms of a vertebral compression fracture can vary depending on the severity of the fracture and the location in the spine where it occurs. Some common symptoms include:
- Pain in the back is often the first symptom of a compression fracture. The pain may be sudden or gradually worsen over time, and may be located in the middle or lower back.
- Vertebral compression fractures can cause a decrease in height, as the bones in the spine lose their shape and structure.
- Kyphosis, or forward rounding of the spine, may occur as a result of vertebral compression fractures. This can cause a hunched posture and difficulty standing up straight.
- In some cases, a compression fracture can compress nerves in the spine, leading to numbness, tingling, or weakness in the arms or legs.
- Compression fractures can make it difficult to move and perform everyday activities, such as walking, bending, and lifting.
Vertebral Compression Fracture Causes
Vertebral compression fractures are a common type of bone fracture that occurs when one or more vertebrae in the spine collapse or become compressed. Several factors can contribute to the development of vertebral compression fractures.
Osteoporosis is a condition that causes bones to become weak and brittle, making them more susceptible to fractures. Vertebral compression fractures are a common complication of osteoporosis, particularly in older adults and postmenopausal women.
A compression fracture can also occur as a result of trauma, such as a fall, car accident, or sports injury. This type of fracture is more common in younger adults and those with a higher level of physical activity.
Cancer that has spread to the spine can weaken the bones and increase the risk of compression fractures. This is known as metastatic bone disease and is a common complication of breast, lung, and prostate cancer.
Certain medical conditions, such as multiple myeloma, hyperparathyroidism, and Paget's disease, can increase the risk of vertebral compression fractures.
Long-term use of corticosteroid medications, such as prednisone, can weaken bones and increase the risk of fractures.
Prevention and treatment of vertebral compression fractures depend on the underlying cause. For example, preventing or treating osteoporosis with medications and lifestyle changes can help reduce the risk of fractures. Treatment options for compression fractures may include pain management, rest, and physical therapy. In severe cases, surgery may be necessary to stabilize the spine and prevent further damage.
Vertebral Compression Fracture Diagnosis
Diagnosing a vertebral compression fracture typically involves a combination of a physical exam, medical history, and imaging tests.
During a physical exam, the doctor will ask about symptoms, such as pain, decreased mobility, and hunched posture, and may perform a neurological exam to check for numbness, tingling, or weakness in the arms or legs. The doctor may also assess the spine for tenderness or deformity.
Medical history is also an important part of the diagnostic process. The doctor will ask about any medical conditions, medications, and past injuries that may have contributed to the development of the compression fracture.
Imaging tests are used to confirm the diagnosis of a vertebral compression fracture and determine the severity of the injury. X-rays are often the first imaging test ordered, as they can show changes in the shape and structure of the vertebrae. However, X-rays may not always detect a compression fracture, particularly if it is in its early stages.
Magnetic resonance imaging (MRI) is another imaging test that may be used to diagnose a compression fracture. MRI uses a magnetic field and radio waves to produce detailed images of the spine, which can show the location and extent of the fracture.
Other imaging tests that may be used include computed tomography (CT) scans, bone scans, and positron emission tomography (PET) scans.
Once a diagnosis of a vertebral compression fracture has been made, the doctor will work with the patient to develop an appropriate treatment plan.
Vertebral Compression Fracture Treatment
Treatment for vertebral compression fractures depends on the severity of the injury and the underlying cause. In many cases, the fracture can be treated with conservative measures that focus on managing pain and promoting healing.
Conservative treatments may include pain management with over-the-counter or prescription pain medications, such as acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), or opioids. Other pain management options may include the use of braces or supports to help support the spine and reduce pain.
Rest is also an important part of the healing process, and patients may be advised to avoid activities that put stress on the spine, such as lifting heavy objects or bending forward. Physical therapy may also be recommended to help improve mobility, flexibility, and strength. Physical therapy can include exercises to help strengthen the back muscles and improve posture, as well as stretches to help relieve pain and improve mobility.
In cases where the compression fracture is caused by an underlying condition, such as osteoporosis, treatment may also focus on addressing the underlying condition to prevent future fractures. This may include medications to improve bone density, such as bisphosphonates, and lifestyle changes to improve bone health, such as increasing calcium and vitamin D intake.
Vertebral Compression Fracture Surgery
Surgery for vertebral compression fractures is typically reserved for cases where conservative treatments have not provided relief or the fracture is causing significant spinal instability. There are several surgical options available, and the specific procedure recommended will depend on the severity and location of the fracture.
One common surgical procedure for vertebral compression fractures is vertebroplasty. During this procedure, the surgeon injects a special type of bone cement into the affected vertebra to stabilize it and relieve pain. The procedure is typically performed under local anesthesia, and most patients are able to go home the same day.
Another surgical option is kyphoplasty, which is similar to vertebroplasty but also involves using a balloon-like device to help restore the height of the affected vertebra before injecting the bone cement. This can help to correct any spinal deformity caused by the compression fracture. Kyphoplasty is also typically performed under local anesthesia and may require a short hospital stay.
Vertebral Compression Fracture Prevention
There are several strategies for preventing vertebral compression fractures. These strategies include maintaining good bone health, avoiding falls, practicing good posture, using proper lifting techniques, and considering bone density testing. Women over 65 and men over 70 may benefit from bone density testing to assess their risk of osteoporosis and vertebral compression fractures.
