Vertebral Compression Fractures: An Introduction

Notice the generalized osteoporosis and the solitary vertebral compression fracture at L2

Fractures of the spine are becoming an increasingly common cause of axial back pain.  Most fractures are degenerative in nature and the largest number of these are vertebral compression fractures resulting from the epidemic of osteoporosis sweeping the country. Vertebral compression fractures are more common in women, paralleling the increased prevalence of osteoporosis. The most common site for these fractures is the lower thoracic and lumbar spine.  The pain of vertebral compression fractures is usually limited to the back unless kyphotic or scoliotic deformities resulting from the fractures produce either spinal stenosis or foramenal stenosis.  While in most cases the pain of a compression fracture improves over a period of 6 weeks to 6 months it may become a source of chronic pain.


The occurrence of the first vertebral compression fracture should be treated as a medical emergency. It is often the harbinger of other fractures to come. Aggressive therapy for osteoporosis should be instituted and progress monitored with bone density measurements, initially every 6 months and then yearly.


The decision about whether to fix a vertebral compression fracture surgically should be based on pain and deformity. Properly done either vertebroplasty or kyphoplasty will rapidly relieve the pain of a vertebral compression fracture. If the deformity is severe, consideration should be given to kyphoplasty, which may reduce the degree of deformity as well as relieve pain.


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