Vertebral Compression Fractures
Back pain can be from spinal insufficiency fractures known as vertebral compression fractures. Vertebral compression fractures occur when the normal vertebral body of the spine is squeezed or compressed to a smaller height. The bone collapses when too much pressure is placed on the vertebrae, resulting in pain, limited mobility, height loss, and spinal deformity.
Vertebral compression fractures can occur as a result of trauma from a fall, a forceful jump, or a car accident, or any other kind of trauma to the spine. Vertebral compression fractures most commonly occur in elderly people and are caused by osteoporosis, a condition that causes a 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.
The most common symptom of 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. Patients who sustain multiple compression fractures may have a hunched back (kyphosis), gastrointestinal problems, hip pain, and shortness of breath.
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 or CT scan : A spinal X-ray or CT scan may be taken to determine the presence of a fracture
- MRI Scan : An MRI of spine may be performed to know if the fracture is old or new and to detect other soft tissue abnormalities
- Bone Scan : A nuclear bone scan may be used to help determine the presence or age of the fracture
- DEXA Scan : Dual Energy X-ray Absorptiometry or DEXA scan, a test to measure bone mineral density, and is typically used to diagnose osteoporosis
The treatment for vertebral compression fractures aims at reducing the pain and allowing the fracture to heal. This is best achieved by pain medications, physical therapy, and optimizing bone health with calcium and vitamin D supplementation. Many patients with osteoporosis may benefit from bisphosphonate medications or other types of medications which build bone to prevent further compression fractures.
In patients who continue to have severe pain despite non-surgical treatment, vertebroplasty can be performed which involves inserting a cement material called polymethylmethacrylate, into the bone of the collapsed vertebra with the needle and syringe under the guidance of X-ray. This technique is performed in order to stabilize the fracture and prevent further collapse.
The most effective way to prevent vertebral compression fractures is to prevent and treat osteoporosis. A well balanced diet, a regular weight bearing exercise program, calcium and vitamin D supplements, smoking cessation, and bisphosphonate or other bone-specific medications may help you to prevent osteoporosis.