Osteoporotic Compression Fractures

About Osteoporotic Compression Fractures

Spinal compression fractures are a type of spine fracture where the vertebral body becomes compressed, or shortened. These fractures can occur after trauma, but are also often observed in patients with osteoporosis, a condition of compromised bone strength, and referred to as osteoporotic compression fractures. Although they can occur anywhere along the spine, they more commonly occur at the junction between the thoracic and lumbar spine.

Compression fractures due to osteoporosis are very common, with 700,000 new cases each year. Although osteoporosis is more typical in postmenopausal women, men can also develop such fractures. Compression fractures may go unrecognized, often presenting with typical back pain, or no pain at all. As a result about two thirds of compression fractures that occur each year are not diagnosed nor treated.

Common Symptoms of Osteoporotic Compression Fractures

Sometimes compression fractures do not cause any symptoms. It is important that woman, especially over the age of 45, take note of any deformity and/or height loss even if no other symptoms are present. Some common complaints associated with a compression fracture  are listed below. These symptoms may compromise an individual’s quality of life and adversely affect the ability to complete daily activity.

  • Back pain
  • Spinal deformity
  • Loss of height
  • Loss of muscle conditioning  
  • Limited spinal mobility
  • Pain when standing/walking

Diagnosis of Osteoporotic Compression Fractures

It is important to correctly diagnose compression fractures that are due to osteoporosis to avoid unwanted side effects and compromised quality of life. Diagnosis of an osteoporotic compression fractures are often difficult because back pain is often associated with many different conditions, making it unlikely that a patient is even checked for a compression fracture. Also an osteoporotic compression fracture may easily be missed on an x-ray.

The start of the diagnostic process includes a complete medical history, family history, and a list of questions relating to the patient’s pain. The next step is a physical examination to try and determine the cause of pain and to rule out other possible conditions. If a vertebral compression fracture is suspected an x-ray will be ordered to confirm the diagnosis.

Additional diagnostic tests that may be considered include:

  • CT scan – defines the extent of the fracture and whether there is the potential for bone fragments to invade the nerve channels.
  • MRI scan – used if a patient’s pain is thought to be caused by something else or if there is a chance that nearby nerves have been affected. An MRI scan can also tell if the fracture is new or old.
  • Nuclear bone scan –  may be used to identify the site and age of the fracture.

Treatment Options for Osteoporotic Compression Fractures

Treatment of osteoporotic compression fractures is usually two stepped, treating the fracture and then the osteoporosis that caused the fracture. Treatment for the fracture will usually consist of nonoperative measures that include:

  • Rest
  • Pain medication
  • Heat/ice for local pain
  • Slow return to mobility
  • Bracing

Generally there are two types of surgery recommended to correct the fracture. These procedures include:

  • Vertebroplasty- a minimally invasive procedure designed to stabilize the bone and eliminate pain, where a thinner cement is injected into the collapsed vertebral.
  • Kyphoplasty- similar to vertebroplasty, designed to reduce pain, stabilize the bone, and restore some or all of the loss vertebral height.

To help prevent more fractures calcium supplements, increased vitamin D, and exercise are usually recommended.