VERTEBRAL COMPRESSION FRACTURES

WHAT IS A VERTEBRAL COMPRESSION FRACTURE?

Vertebral compression fracture
The spinal column is made up by bones named vertebrae. A vertebra can break just like any other bone in the body. When the vertebral body collapses, a vertebral compression fracture is produced. These fractures happen more commonly in the thoracic spine (the middle portion of the spine), especially the lower part. Vertebral fractures usually happen due to osteoporosis, a fall from a significant height, or some types of tumours.
Vertebral compression fracture
 

CAUSES OF VERTEBRAL COMPRESSION FRACTURES

Vertebral compression fractures are generally produced due to an excessive pressure on the vertebral body. They happen when the bone tissue on the inside of the vertebral body is crushed or compressed, for it eventually collapses and its front part becomes wedge-shaped.

Vertebral compression fractures can occur for several different reasons.

Osteoporosis

Osteoporotic bone

Osteoporosis is the most common cause, and when an individual suffers from osteoporosis, even just sneezing or sitting down could cause a fracture of the vertebral body. However, a tumour or trauma can also cause a compression fracture: a traffic accident or a fall could cause a traumatic fracture of a vertebra, and a tumour could weaken the bone, causing a fracture.

Vertebral fractures account for the great majority of osteoporosis-related fractures. Osteoporosis induces a decrease in the amount of mineralised bone, and this means that the bone structure becomes more fragile and, thus, more susceptible to breakage. Any bone can be affected, but osteoporosis starts at the lower thoracic spinal column and at the neck of the femur. There are no symptoms associated with osteoporosis, it is a gradual process that often progresses undiscovered and, in addition, cannot be diagnosed using X-rays. For diagnosis, a bone density test is necessary.

Osteoporotic bone
 

Trauma

A fall from a significant height cause a vertebral compression fracture
Vertebral compression fractures due to trauma can be caused by a fall, an extreme jump, a traffic accident, or any other even that stresses the spine past its breaking point.
A fall from a significant height cause a vertebral compression fracture
 

Tumor

Destruction of the vertebral body by a metastatic tumour

A tumour that spreads to the spine weakens the spine’s ability to support the body and withstand normal stress. The vertebrae are a common site for many cancers to spread; and once there, the cancer may destroy part of a vertebra, weakening the bone until it collapses.

Destruction of the vertebral body by a metastatic tumour
 

SYMPTOMS OF VERTEBRAL COMPRESSION FRACTURES

Pain can range from mild to severe and usually worsens with movement. If the spinal cord is involved, pain as well as numbness and/or weakness may radiate into the arms and legs. A mild back pain could be much more than a simple problem is it is caused by a compression fracture.

If a vertebral compression fracture is caused by a sudden, forceful injury, a severe pain in the back will probably be felt; but if the bone collapse is gradual, such as an osteoporosis-related fracture, the pain will usually be milder. However, there might not be any pain at all until the bone actually breaks.

Additional symptoms of a vertebral compression fracture might include height loss or stooped posture (kyphosis). With each fracture, additional stress is put on surrounding vertebrae, which are then more likely to fracture. These additional fractures can cause the stooped posture, and once this occurs, it can affect ability to breathe and do simple daily activities.

TREATMENT OPTIONS

When a vertebral compression fracture is diagnosed, conservative treatments are sometimes applied. They can include analgesics, such as aspirin or ibuprofen, as well as rest and orthesis (external bracing, corset). These conservative methods aim to relieve pain and/or allow healing to take place. If healing does not occur, surgical treatment may be necessary.

Vertebroplasty and kyphoplasty are surgical procedures specifically used to treat vertebral compression fractures.

Vertebroplasty is a minimally invasive procedure in which special cement is injected into the broken vertebral body. This treatment is mainly used to ease the pain and improve the strength of the vertebral body.

Kyphoplasty is a minimally invasive procedure in which a tube with a deflated balloon is slipped inside the broken bone. Once inside, the balloon is first inflated and then removed so that the space it has left in the vertebra can be filled with the bone cement.

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