Vertebral compression fractures

Most compression fractures are found in elderly patients with osteoporosis. These fractures generally do not cause injury to the spinal cord. In these patients, the osteoporosis is treated with prescription medications and calcium supplements to prevent more fractures.

Otherwise, the pain from these fractures is treated with pain medicines and bed rest at first. Narcotics are often needed. Some health care providers recommend back braces, but these may further weaken the bones and increase your risk of developing more fractures in the future.

Patients may benefit from some physical therapy to help with movement and building up muscle strength around the spine. A medicine called calcitonin may help relieve bone pain.

If severe and disabling pain is still present after 2 months or more of bed rest, pain medicines, and physical therapy, surgery can be option. Your doctor will discuss surgery options with you. Two minimally invasive techniques are available:

• Balloon kyphoplasty: A large needle is inserted into the compressed vertebra. A balloon is inserted into the bone through the needle and inflated, restoring the height of the vertebra. Cement is injected into this space to make sure it does not collapse again. This procedure is generally done under general anesthesia.
• Vertebroplasty: This is a similar procedure in which cement is injected into the bone of the vertebra. This procedure is done under local anesthesia and sedation.

If the fracture is caused by a tumor, a piece of the bone may need to be surgically removed and examined under a microscope (biopsy). Then the tumor is treated.

Fractures from trauma often require a brace for 6 - 10 weeks to protect the bone as it heals. If there is bone in the spinal canal, you may need surgery to remove the bone and fuse the vertebrae together to stabilize the spine.

Further spine surgery is almost always necessary if there is any loss of function because of bone pressing on the spinal cord or spinal nerves.

Images

Compression fracture

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Review Date: 12/01/2010
Reviewed By: David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)