Vertebral Compression Fractures
Back pain is an indication of stress 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. In very severe compression fractures, the back of the vertebral body is pushed into the spinal canal and pressure is placed on the spinal cord.
Vertebral compression fractures can occur because of trauma from a fall, a forceful jump, or a car accident or a tumour that spreads to the spine from elsewhere. Vertebral compression fractures usually 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 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: A spinal X-ray may be taken to determine the presence of a fracture.
- MRI Scan: A MRI of the 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.
Treatment of Vertebral Compression Fractures
The treatment for vertebral compression fractures aims at reducing the pain and stabilising and repairing the fracture. This is best achieved by medications, back braces, bed rest, and physical therapy.
Non-steroidal anti-inflammatory drugs such as ibuprofen or naproxen may be prescribed to relieve bone, muscle and nerve pain. Your doctor may prescribe a back brace that supports the back and restricts movement.
Surgery may be needed in patients who continue to have severe pain despite non-surgical treatment. Two minimally invasive surgical procedures for treating vertebral compression fractures are:
- Kyphoplasty: In this procedure, a large needle is introduced into the spine with a balloon called a bone tamp and inflated until it expands to the desired height. The created space is then filled with or injected with orthopaedic cement called polymethylmethacrylate (PMMA). This procedure restores the height of the vertebrae and reduces the deformity.
- Vertebroplasty: This technique 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 to stabilise the fracture and prevent further collapse.
- Fracture Fixation with Pedicle screws augmented with Cement - the fracture can also be fixed with pedicle screws and cement to ensure that the screws have a good purchase in the bone and do not loosen as a result of the osteoporosis.
Prevention of Vertebral Compression Fractures
The most effective way to prevent vertebral compression fractures is to prevent osteoporosis. A well-balanced diet, regular exercise program, calcium and vitamin D supplements, smoking cessation, oestrogen hormone replacement for women and practicing good posture may help you to prevent osteoporosis.