Key Points about Spinal (Vertebral) Compression Fractures
- A spinal compression fracture occurs when a bone in the spine collapses. In most cases, it leads to severe back pain that limits mobility
- Spinal compression fractures are generally caused by osteoporosis but can also be caused by trauma or metastatic cancer that spreads to the spine.
- Symptoms of a spinal compression fracture include back pain that intensifies over time, loss of height, the curve in the spine, and inability to twist at the waist.
- Thin, white, or Asian women over 50 are at high risk of developing spinal cord compression fractures.
- Spinal compression fractures can be diagnosed with a physical exam and diagnostic imaging.
- Many patients can be treated with nonsurgical therapies such as pain medication, activity modification, and braces. Other patients will need surgical treatments such as vertebroplasty, kyphoplasty, and spinal fusion surgery.
A spinal compression fracture, also known as a vertebral compression fracture, occurs when a bone in the spine collapses. Typically, a spinal compression fracture happens in the thoracic spine (middle spine).
Generally, spinal compression fractures, lead to severe back pain that limits your mobility and causes health decline.
Treatment typically involves a surgical procedure that stabilizes the bone. The goal of treatment is to reduce pain and restoration of mobility.
Spinal (vertebral) compression fractures causes
Typically, a spinal compression fracture occurs when too much pressure is placed on the spine.
Common causes of spinal compression fractures include:
- As your bones thin, they are often too weak to bear normal pressure and collapse during your daily activity.
- Car accidents, falls or contact sports can cause a spinal compression fracture.
- Metastatic disease. As cancer spreads to the spine, it can weaken the vertebrae and lead to a spinal compression fracture.
Spinal (vertebral) compression fractures symptoms
The primary symptom of a spinal compression fracture is back pain. In many cases, it starts gradually and intensifies over time.
Other symptoms of spinal compression fractures include:
- Pain that worsens when standing or walking.
- Inability to bend or twist your body.
- Height loss.
- Curve in the spine.
Spinal (vertebral) compression fractures complications
If left untreated, spinal vertebral fractures can lead to increased morbidity or mortality.
If you had one vertebral fracture, you are much more likely to sustain a new one within 12 months.
Spinal (vertebral) compression fractures risk factors
People with osteoporosis or cancer that has metastasized to the bones are the groups of people are most likely to suffer a spinal compression fracture.
Because people with osteoporosis are the most likely to suffer a compression fracture, people who fit into these categories are more at risk:
- White or Asian women
- People over the age of 50.
- Thin women.
- Women who go through early menopause.
Spinal (vertebral) compression fractures prevention
If you have osteoporosis, it is essential to treat the underlying condition to prevent future spinal compression fractures. Taking calcium supplements, getting vitamin D, quitting smoking, exercising, and preventing falls are all-natural ways to prevent osteoporosis.
There are also a variety of medications that slow the progression of osteoporosis, including:
- Bisphosphonate drugs.
- Synthetic hormones.
- Estrogen-like drugs that slow bone loss.
- Medications used to increase bone strength and reduce fractures
- Hormone replacement therapy.
Spinal (vertebral) compression fractures diagnosis
Your doctor can diagnose a spinal vertebral fracture. It is essential to seek care right away due to the adverse effects if left untreated or misdiagnosed.
Diagnosing a spinal compression fracture is complicated because several conditions or variables can cause back pain. Your doctor will take a full medical history evaluating when the pain started, where the pain is, what activities make the pain feel worse, and if the radiating to other parts of the body.
If your doctor suspects you have a spinal compression fracture, your doctor will test for sensitivity or tenderness around the vertebrae along the spine.
Your doctor will likely also order diagnostic testing, such as:
- CT scan. A computerized tomography scan can confirm if the fractured bone is stable or if adjacent nerves are being affected by the fracture.
- MRI scan. A magnetic resonance imaging scan can determine if your doctor suspects that nerves are affected.
- Nuclear bone scan. A nuclear bone scan can help determine where the fracture occurred.
Spinal (vertebral) compression fractures treatment
Your doctor will develop a customized treatment plan for your case. If your condition is minor, he or she may recommend:
- Pain medications, such as ibuprofen or naproxen.
- Ice and heat. Alternate ice and heat to the area for the week after the injury.
- Doctor approved home stretching and strengthening program.
Nonsurgical treatments for spinal compression fractures include:
- Pain medications — Pain medications can help relieve pain associated with spinal cord fracture.
- Activity modification — A short period of rest (no longer than a few days) should be taken to allow the area to heal. More extended periods of inactivity are not advised.
If the pain associated with spinal cord compression fracture persists after nonsurgical interventions, you may need a minimally invasive surgical procedure. The goal of surgical treatment is to stabilize the spine. Surgical therapies for spinal cord fractures include:
- During vertebroplasty, your doctor will insert a needle into the spine, inject a bone cement mixture into the damaged vertebrae and allow it to harden.
- During kyphoplasty, a tube is inserted into the fractured vertebra; a balloon is inflated to make space for a cavity where bone cement is injected. The bone cement hardens in approximately 10 minutes.
- Spinal fusion surgery — Spinal fusion surgery can eliminate motion between vertebrae. During a spinal fusion, the two vertebrae are fused using metal screws, plates, and rods that are bolted to the back of the spine. Spinal fusion is only used as a last resort.
When to Seek Care
Schedule an appointment immediately if you suspect you have a spinal compression fracture.
Before your appointment, make sure to take notes on:
- When the symptoms started.
- Any significant event that caused your symptoms.
- Family history of spine medical issues.
- Questions for your doctor.
Once diagnosed, follow your doctor’s instructions carefully. If you are unsure what to do, contact your doctor. Do not participate in strenuous activities or lift heavy objects until your doctor has cleared you. Schedule a follow-up appointment at the recommended time. If your symptoms worsen, call your doctor right away