Compression Fractures

Overview

Compression fractures of the back are broken vertebrae, which are the bones of the spine.

Causes

Causes

Compression fractures of the vertebra may be caused by:

  • Osteoporosis (the most common cause),
  • Trauma to the back
  • Tumors that started in the bone or spread to the bone from elsewhere
  • Tumors that start in the spine, such as multiple myeloma

 

Multiple fractures may lead to kyphosis, a hump-like curvature of the spine.

Symptoms

Symptoms

Compression fractures may occur suddenly, causing severe back pain that is:

  • Most commonly felt in mid to lower part of the spine, but may also be felt on the sides or in the front.
  • Described as “knifelike” and usually disabling, often taking weeks to months to go away

 

Compression fractures due to osteoporosis may cause no symptoms at first and may only be discovered when x-rays of the spine are done for other reasons. Over time, the following symptoms may occur:

  • Back pain that starts slowly, which gets worse with walking but is not felt when resting
  • Loss of height, as much as 6 inches over time
  • Stooped over posture or kyphosis, also called a “dowager’s hump”

 

Pressure on the spinal cord from hunched over posture may rarely produce symptoms of:

Exams and Tests

Exams and Tests

Your doctor will perform a physical exam. This may reveal:

  • A humpback, or kyphosis
  • Tenderness over the affected spinal bone or bones

 

spine x-ray shows at least one compressed vertebra that is shorter than the other vertebrae.

Other tests that may be done:

  • A bone density test to evaluate for osteoporosis
  • A CT or MRI scan if there is concern that the fracture was caused by a tumor or severe trauma (such as a fall from a height or car accident)

Treatments

Treatments

Most compression fractures are seen in older people with osteoporosis. These fractures generally do not cause injury to the spinal cord. The condition is usually treated with medicines and calcium supplements to prevent further fractures.

Pain may be treated with:

  • Pain medicine, including narcotics
  • Bed rest

 

Other treatments may include:

  • Back braces, but these may further weaken the bones and increase your risk of more fractures
  • Physical therapy to improve movement and strength around the spine
  • A medicine called calcitonin to help relieve bone pain

 

Surgery may be done if  you have severe and disabling pain for more than 2 months that does not get better with other treatments. Surgery can include:

 

Other surgery may be done to remove some bone if the fracture is due to a tumor.

After surgery you may need:

  • A brace for 6-10 weeks if the fracture was due to an injury
  • More surgery to join certain spine bones together or to relieve pressure on a nerve

Outlook (Prognosis)

Outlook (Prognosis)

Most compression fractures due to injury heal in 8 – 10 weeks with rest, bracing, and pain medications. However, recovery can take much longer if you had surgery.

Fractures due to osteoprosis usually become less painful with rest and pain medications, but some can lead to long-term (chronic) pain and disability.

Medicines to treat osteoporosis can help prevent future fractures. However, they cannot reverse damage that has already occurred.

For compression fractures caused by tumors, the outcome depends on the type of tumor involved. Some common tumors that involve the spine include:

  • Breast cancer
  • Lung cancer
  • Lymphoma
  • Prostate cancer

Possible Complications

Possible Complications

Complications may include:

  • Failure of the bones to fuse after surgery
  • Humpback
  • Spinal cord or nerve root compression

When to Contact a Medical Professional

When to Contact a Medical Professional

Call your health care provider if:

  • You have back pain and you think you may have a compression fracture
  • Worsening symptoms or difficulty with controlling your bladder and bowel function

Prevention

Prevention

Treating and preventing osteoporosis is the most effective way to prevent these fractures.

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. “Compression fractures of the back.” National Institutes of Health. (2011): n. page. Web.
http://www.nlm.nih.gov/medlineplus/ency/article/000443.htm.