Compression Fracture

Compression Fracture Overview

A compression fracture refers to a type of fracture or break in your vertebrae. Vertebrae are the bones in your back that are stacked on top of each other. They collectively make your spine.
Compression fractures can cause your vertebrae to collapse, making them shorter in height. Vertebral fractures are usually followed by acute back pain. They may also lead to chronic pain, deformity in the form of thoracic kyphosis, loss of height, crowding of internal organs, and loss of muscle and aerobic conditioning due to lack of activity and exercise. This collapse can also cause pieces of bone to press on the spinal cord and nerves, decreasing the amount of blood and oxygen that gets to the spinal cord. We, at Spine Physicians Institute, have seen and successfully treated this condition in many patients.
One of the above problems, or a combination of them can lead to changes in the patient’s self-image. It can adversely affect self esteem and the ability to carry on the normal activities of daily life.
The majority of the damage in compression fractures in limited to the front of vertebral column. Hence, the fracture is usually stable and it is rarely associated with any nerve or spinal cord damage.
Not all compression fractures are capable of inducing pain in the patients. Without significant occurrence of symptoms or deformity in the patient’s spinal column, no intervention is required.

Causes

Osteoporosis is the most common cause of compression fractures. It is a type of bone loss that causes the bones to break easily. It may also be caused by injury to the spine, such as from a car accident or sport. Tumors in the spine are another cause of compression fractures. Tumors might start in the vertebrae, but more commonly they spread to the spine from another area in the body.

Symptoms

Compression Fractures usually do not show any symptoms in the beginning of development. Later symptoms may include one or a combination of the following;

• A back pain that keep worsening. It could be relieved by lying down and worsened by standing upright or lifting weight.
• A decrease in height.
• Limited movement in spine, which hinders bending or twisting.
• A stooped over posture, also called as Kyphosis.
• Numbness or tingling, weak muscles, problems walking, and possible trouble controlling your bowels or bladder because of nerve damage
• Sudden and severe debilitating back pain may be felt for rapid onset of fractures.

Diagnosis

The physician examines the medical history, recent injuries and does a physical exam. The examination is done to see if patient feels pain or whether the upper spine is hunched forward. X-ray, CT scan or MRI scan can also be used as diagnostic tools.
For osteoporosis, a special type of X-ray called a dual-energy X-ray absorptiometry (DEXA) or bone density scan is done. These tests show if osteoporosis is the cause of the fracture.

Treatment

Vitamin D, Calcium and bone strengthening supplements are necessary for compression fractures caused by osteoporosis. The goal is to make the bones stronger and prevent further fracturing. Pain medication, bed rest and physical therapy might also be recommended. A back brace can be worn for assistance.
Following two surgical options are used for treatment;

• Vertebroplasty. A quick setting cement is injected into the broken vertebrae to strengthen the area and lessen the pain.
• Kyphoplasty. Small balloons are used to expand fractured space. The balloons are removed to fill the area with quick setting cement.

Radiation therapy might be used if the symptoms are caused by cancerous tumor. The surgery can remove some of the bone and treat the tumor. Fusion surgery may be used to treat the fracture caused by injury. It repairs the bone and joins the vertebrae together.

Epidemiology

Spinal compression fractures that occur as a result of osteoporosis are actually quite common. They occur in approximately 700,000 people within U.S. annually.
Osteoporosis is especially common in postmenopausal women. In fact, it is estimated that approximately 25% of all postmenopausal women in the United States suffer from a vertebral compression fracture. It is also estimated that approximately four times as many women have low bone mass or osteoporosis as men.
However, it occurs in men as well. As many as 25% of men over age 50 will suffer a bone fracture (e.g. hip or spine) due to osteoporosis.
The fracture is not always recognized or accurately diagnosed. The patient’s pain is usually misdiagnosed as general back pain resulting from common reasons. Such as from a muscle strain, a soft tissue injury or simply by the progression of age. That is why approximately two thirds of the vertebral fractures that occur each year are not diagnosed. By not being diagnosed, they are not treated either.
For more questions, contact our offices located in Dallas, Irving, Red Oak, Plano, Southlake, Grapevine, Colleyville and Duncanville marketplaces.