Vertebral compression fractures are common in the thoracic and lumbar vertebrae due to osteoporosis. Symptoms include back pain and height loss. Treatment includes rest, pain management, and a back brace. Kyphoplasty is a surgical option. Preventative measures include bone density screening, medication, calcium and vitamin D supplements, and weight-bearing exercise.
A vertebral compression fracture is a break in the round, thick body of the vertebral bone in the back. This type of fracture can occur after trauma to the vertebra or, more commonly, from the bone disease osteoporosis. When a vertebral compression fracture occurs, the bone is flattened or compressed and can lead to shortening in height.
The spine is made up of four regions: the cervical, thoracic, lumbar and sacral vertebrae. Vertebral compression fractures commonly occur in the lower-middle regions of the spine in the thoracic or lumbar vertebrae. In the patient with osteoporosis, simple movements such as turning or twisting can lead to a fracture.
Bone tissue undergoes continuous turnover with periods of bone growth followed by periods of bone degradation. Osteoporosis develops when the rate of bone growth slows down and the bones become spongy and very brittle. Osteoporosis can develop in women as they go through menopause and bone density decreases. Men also develop osteoporosis, albeit at an older age than women, and are also prone to vertebral compression fractures.
Back pain is usually the primary indication that a fracture has occurred. Your doctor may order an X-ray or magnetic resonance imaging (MRI) of your spine to diagnose your fracture. Home treatment involves applying ice to the fracture for the first week to reduce swelling or inflammation. After the first week, heat can be used to prevent stiffness. It is also important for the patient to rest to allow the fracture to heal.
Pain from a vertebral compression fracture can be severe. The patient may experience a significant reduction in pain during bed rest due to the fact that standing and sitting put weight on the vertebra and can cause pain. The patient should discuss pain management and treatment choices with a physician. Any loss of sensation or function may indicate nerve damage and a doctor should be consulted immediately
If left untreated, vertebral compression fractures usually heal in about 90 days. During this time, in addition to pain management and rest, your doctor may recommend a back brace. The back brace should be worn standing or sitting to provide extra support for the vertebrae.
There is a surgical option, known as kyphoplasty, that can be used to repair a vertebral compression fracture. This procedure involves inserting a balloon into the body of the vertebra to restore height to the bone. Cement is then injected into the bone to stabilize the fracture. In a patient with osteoporosis, one risk with this procedure is that the newly opened vertebra puts pressure on the neighboring vertebra and causes another fracture.
Men and women who are susceptible to osteoporosis should have their bone density screened periodically. Patients with low bone density may be given medications to slow the effects of osteoporosis. Your doctor may also recommend supplementing your diet with calcium and vitamin D. Exercise with weights has also been shown to strengthen bones. A combination of these activities can help prevent a painful vertebral compression fracture.
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