Vertebral Compression Fracture

A Vertebral Compression Fracture (VCF) occurs when one of the bones in the spine (vertebrae) collapses, which can lead to pain, deformity, and loss of height. This condition is often associated with osteoporosis but can also result from trauma or certain cancers. Here’s essential information for patients diagnosed with a vertebral compression fracture:

1. Causes

• Osteoporosis: The most common cause, where weakened bones are more susceptible to fractures, even from minor falls or daily activities.
• Trauma: High-impact injuries such as car accidents or falls can cause fractures in healthy vertebrae.
• Cancer: Cancers that spread to the bones (metastatic cancer) or bone cancers can weaken vertebrae, leading to fractures.
• Chronic Conditions: Conditions like rheumatoid arthritis or long-term steroid use can increase fracture risk.

2. Symptoms

• Sudden Back Pain: Intense, sharp pain in the mid or lower back, often occurring suddenly after a minor injury or with no apparent cause.
• Height Loss: A noticeable loss of height due to the collapse of the vertebra.
• Spinal Deformity: A stooped or hunched posture (kyphosis) due to the compression of multiple vertebrae.
• Limited Mobility: Difficulty moving or performing daily activities due to pain.
• Pain Worsening with Movement: The pain may intensify when standing, walking, or bending, and improve when lying down.

3. Diagnosis

• Physical Examination: A healthcare provider will assess pain levels, spinal alignment, and range of motion.
• Imaging Tests:
  • X-rays: To visualize the fractured vertebra and assess the extent of compression.
  • MRI or CT Scans: These provide detailed images to evaluate the fracture, check for nerve compression, and rule out underlying conditions like tumors.
• Bone Density Test (DEXA Scan): To check for osteoporosis, which might have contributed to the fracture.

4. Treatment Options

• Conservative Treatments:
  • Pain Management: Over-the-counter pain relievers (e.g., acetaminophen, NSAIDs) or prescribed medications, including opioids in severe cases.
  • Rest: Short-term bed rest may be recommended to allow the fracture to heal, but prolonged inactivity should be avoided.
  • Bracing: A back brace can provide support, reduce pain, and help stabilize the spine during healing.
  • Physical Therapy: Gentle exercises to strengthen the back muscles, improve posture, and enhance mobility.
  • Osteoporosis Treatment: If osteoporosis is present, medications such as bisphosphonates, calcium, and vitamin D supplements may be prescribed to strengthen bones and prevent future fractures.
• Minimally Invasive Procedures:
  • Kyphoplasty: A procedure in which a balloon is first inserted through a needle and opened to help restore the height of the compressed vertebra. Subsequently a medical “cement” material is injected into the fractured bone, hardening it from the inside which generally reduces pain significantly.
• Surgical Options (rare and for severe cases):
  • Spinal Fusion: Fusing two or more vertebrae together to provide stability if the fracture severely compromises the spine's structure.

5. Managing the Condition

• Activity Modification: Avoiding activities that strain the back, lifting heavy objects, or high-impact sports.
• Pain Management: Following a pain management plan, including medication, ice/heat therapy, and gentle movement.
• Nutrition: Ensuring adequate intake of calcium and vitamin D to support bone health.
• Fall Prevention: Implementing safety measures at home (e.g., removing tripping hazards, using assistive devices) to prevent falls, especially for those with osteoporosis.
• Regular Monitoring: Routine follow-ups to monitor healing and bone health, especially if osteoporosis is a concern.

6. Prognosis

Most vertebral compression fractures heal within 8-10 weeks with conservative treatment, though some patients may experience chronic pain. Early intervention, especially for osteoporosis, can prevent future fractures. Procedures like vertebroplasty and kyphoplasty often provide significant pain relief and improve quality of life for patients with severe or persistent symptoms.