In a compression fracture of the vertebrae, the bone tissue of the vertebral body collapses. More than one vertebra may be affected. This condition may be caused by osteoporosis (the most common cause), tumor, or trauma to the back. When the fracture occurs as a result of osteoporosis, the vertebrae in the thoracic (chest) and lower spine are usually affected, and symptoms may be worse with walking. With multiple fractures, a forward curvature of the spine may result. Pressure on the spinal cord may occur producing symptoms of numbness, tingling or weakness. Symptoms depend upon the area of the back that is affected, however, most fractures are stable and do not produce neurological symptoms.
- No symptoms
- Back pain with sudden or chronic onset
- Shortened height
- Kyphosis (forward bent posture)
Signs and tests:
- Forward bent over posture. There is also tenderness over the injured vertebrae.
- X-Rays may show a compressed vertebra that is shorter than the others.
Most compression fractures are found in elderly patients with osteoporosis. These fractures generally do not cause injury to the spinal cord. Treatment includes treating the osteoporosis with prescription medications and supplemental calcium. Otherwise, these fractures are treated symptomatically with pain medicines. Some orthopedic practitioners employ back braces, but these may weaken the bones more and predispose the patients to more fractures in the future. While orthopedic surgery is rarely needed, there is a new, minimally invasive technique (caled Vertebroplasty) that can help patients with intractable pain from compression fractures. A needle is inserted with X-ray guidance into the compressed vertebra. A balloon is inserted into the bone through the needle and inflated, restoring the height of the vertebra. Sometimes, cement is injected into the bone to make sure it does not collapse again. If the fracture is caused by tumor, the tumor may need a biopsy. Fractures from trauma often require rigid bracing to protect the bone as it heals for 6 to 10 weeks. If there is bone in the spinal canal, surgery to remove the bone and fuse the vertebra together to stabilize the spine may be necessary. Surgery is almost always necessary if there is any loss of function because of bone pressing on the spinal cord or spinal nerves.
Most compression fractures from trauma will heal in 8 to 10 weeks with rest, bracing, and pain medications. This recovery time is extended by many weeks if surgery is necessary. Osteoporotic fractures usually become less painful with rest and pain medications, but some do cause chronic pain and can be a source of great disability. The prognosis of compression fractures caused by tumor is completely dependent on the type of tumor. Some common tumors that involve the spine include breast cancer, prostate cancer, lung cancer, and lymphoma. A biopsy can be followed by a surgical treatment such as vertebroplasty (mentioned above).