Vertebral Compression Fractures

Vertebral Compression Fracture treated by top doctors in AlaskaAn achy back is a common complaint; nearly everyone in the US will have this ailment at some point. One of the more common causes of back pain is a vertebral compression fracture. One or more of the 33 vertebrae in the spine have either broken or collapsed. While the majority of these injuries remarkably are asymptomatic – or cause no significant pain – they can also result in limited movement and long term, nagging pain.

How do vertebrae crack? Most likely, the cause of the break is osteoporosis. This condition is often seen with age and is caused when bones soften. A compression fracture of this sort may cause sudden pain – or, it may cause nagging, long-term pain felt after attempting minor movements, like bending and lifting. Vertebral compression fractures do not, therefore, present in one consistent manner. They can cause no pain. Or they can cause severe discomfort from something as insignificant as sitting.

These cracked vertebrae are most common in the upper, or thoracic, back – down to the lower, or lumbar, back. While pain normally resolves within a month, severe pain or pain that lasts longer than four weeks is an indication of further medical care. In this circumstance a physician will likely conduct a comprehensive history, exam and possibly diagnostic imaging. Key indicators are kyphosis – or having a humpback – and loss of height with time. A simple X-ray can see if vertebrae are compressed or broken, though a bone scan for osteoporosis may also be in order.

Treatment for such compression fractures span the same wide range as the pain associated. Conservative care may include medications, physical therapy and lifestyle changes. A calcium rich diet will likely be recommended. Surgical procedures for more severe cases may include:

The two most common, and minimally invasive, surgical procedures include a percutaneous vertebroplasty. During this procedure, cement is pushed into the fractured bone to provide more support and allow for healing. Another surgical option is a balloon kyphoplasty when a small balloon is injected into the injured vertebrae and slowly inflated to the original size. While the surgeries are safe and will often help with recovery, there are always risks too. If the fracture was caused from osteoporosis, the softening of the bones must also be treated to protect the rest of the skeletal frame.

References

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  2. Nidus Information Services. (2011). Compression fractures of the back. Patient Handouts. MD Consult Web site, Core Collection. Retrieved from http://www.mdconsult.com.ezproxy1.library.arizona.edu/das/patient/body/262696692-3/1175420669/10041/31768.html.
  3. Sheon, R.P.; Rosen, H.N. (2011). Clinical manifestations and treatment of osteoporotic thoracolumbar vertebral compression fractures. In: UpToDate, Basow, DS (Ed), UpToDate, Waltham, MA.
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  5. Kado, D.M. (2010). Overview of hyperkyphosis in older persons. In: UpToDate, Basow, DS (Ed), UpToDate, Waltham, MA.
  6. Nidus Information Services. (2011). Compression fractures of the back. Patient Handouts. MD Consult Web site, Core Collection. Retrieved from http://www.mdconsult.com.ezproxy1.library.arizona.edu/books/page.do?eid=4-u1.0-B978-1-4160-2261-9..50040-9–cesec8&isbn=978-1-4160-2261-9&sid=1175420675&uniqId=262696692-3#4-u1.0-B978-1-4160-2261-9..50040-9–cesec10.
  7. Evans, A.J.; et al. (2009). Prospective assessment of pain and functional status after vertebroplasty for treatment of vertebral compression fractures. J NeuroIntervent Surg. Vol 1, 66-70.