Compression Fractures

Description

Vertebral compression fractures typically occur in the elderly osteoporotic spine, oftentimes with a fall or even with no known injury. These compression fractures result when a bone in the spine collapses. This collapse of the vertebra usually occurs at the bottom part of the thoracic spine (T11 and T12), and/or the first vertebra of the lumbar spine (L1), but any levels may be affected. The fracture causes the bone to lose height and form a wedge shape. Vertebral fractures are usually due to conditions such as: osteoporosis (thinning and weakening of the bones), trauma, or any type of physical injury (a fall). In very severe compression fractures, the back of the vertebral body may protrude into the spinal canal putting pressure on the spinal cord. The spine can withstand an enormous amount of pressure; however, if the force is too great for the vertebra to withstand, one or more of them may fracture. Osteoporosis is the leading cause of all compression fractures. This disease thins the bones, making them too weak to bear normal pressure. Compression fractures alter the shape of the vertebra, yet usually heal on their own within eight to twelve weeks.

Symptoms

Patients with compression fractures usually have point tenderness near the specific vertebra fractured. They may also have difficulty walking and performing activities of daily living.

Treatment

Most commonly, patients are treated with anti-inflammatory medication, pain medication, activity reduction, and bracing. Vertebroplasty (injecting cement into the bone to stabilize the fracture) may be warranted. This is a relatively new technique, which has shown great promise in early pain reduction and stabilization of the fracture.

Procedure

Vertebroplasty involves the injection of liquid bone cement (polymethyl-methacrylate) into painful compression fractures through a percutaneous or very small incision. The cement becomes hardened in ten minutes, thus giving significant reinforcement to the broken vertebra and preventing further fracture and collapse. The procedure typically provides immediate pain relief for 80-85% of patients.