Osteoporotic Vertebral Compression Fractures

Osteoporotic Vertebral Compression Fractures



What are Vertebral Compression Fractures?

Back pain is an indication of stress fractures known as vertebral compression fractures. Vertebral compression fractures occur when the normal vertebral body of the spine is squeezed or compressed. The bone collapses when too much pressure is placed on the vertebrae, resulting in pain, limited mobility, loss of height and spinal deformity. In very severe compression fractures, the back of the vertebral body is pushed into the spinal canal and pressure is placed on the spinal cord.

Causes of Vertebral Compression Fractures

Vertebral compression fractures can occur because of trauma from a fall, forceful jump, car accident or tumor that spreads to the spine from elsewhere. Vertebral compression fractures are usually caused by osteoporosis, a condition that causes thinning of the bone. The thinning bones can cause tiny fractures during normal activities. In severe cases of osteoporosis, a simple movement like bending forward can cause spinal compression fracture, resulting in kyphosis, a hump-like curvature of the spine.

Symptoms of Vertebral Compression Fractures

The most common symptom of a vertebral compression fracture is severe pain in your back, which worsens on standing or walking and decreases when resting. You may also feel weakness and numbness in the affected areas, disability, and limited spinal mobility. You may also often notice a loss of overall height. If you sustain multiple compression fractures, you may have a hunched back (kyphosis or "dowager’s hump"), gastrointestinal problems, hip pain and shortness of breath.

Diagnosis of Vertebral Compression Fractures

Your doctor will carefully examine you based on the symptoms and medical history. Your doctor may also recommend other diagnostic tests such as:

  • X-ray : A spinal X-ray may be ordered to determine the presence of a fracture.
  • MRI scan : An MRI of the spine may be performed to determine if the fracture is old or new, and to detect other soft tissue abnormalities.
  • Bone scan : A nuclear bone scan may be ordered to help determine the presence or age of the fracture.
  • DEXA scan : Dual-energy X-ray absorptiometry (DEXA) scan is a test to measure bone mineral density, and is typically ordered to diagnose osteoporosis.

Treatment

The most step is to find out the cause of osteoporosis and treat it with medicines. The management of primary osteoporosis entails nutritional supplementation of calcium and vitamin D. The various drugs include oral medication, intra-venous or subcutaneous injections of the latest drugs. This is decided in conjunction with an endocrinologist.

The fractures are managed by limited rest, pain-killers, braces and exercises once the pain subsides. when the fracture fails to unite and causes mechanical back pain and/or nerve compression a surgical intervention may be warranted, a simple procedure carried out is a "vertebroplasty", which is an injection of bone cement in the fractured vertebra under local anaesthesia. Some fractures may require fixation and decompression in addition to vertebroplasty.