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A vertebral compression fracture is a break in the round thick body of the vertebral bone in the back. This kind of a fracture can occur after a trauma to the vertebra or, more commonly, from the bone disease osteoporosis. When a vertebral compression fracture occurs, the bone is flattened or compressed and can lead to a shortening in height.
The vertebral column is made up of four regions: the cervical, thoracic, lumbar, and sacral vertebrae. Vertebral compression fractures commonly occur in the middle to lower regions of the spine in the thoracic or lumbar vertebrae. In the patient with osteoporosis, simple movements such as turning or twisting can lead to a fracture.
Bone tissue continuously undergoes turnover with periods of bone growth followed by periods of bone degradation. The bone disease osteoporosis develops when the rate of bone growth slows down and bones become spongy and very fragile. Osteoporosis can develop in women as they go through menopause and bone density decreases. Men also develop osteoporosis, albeit at a later age than women, and they are susceptible to vertebral compression fractures as well.
Back pain is usually the primary indication that a fracture has occurred. The physician may order an x-ray or a magnetic resonance imaging (MRI) of the spinal column to diagnose the fracture. Treatment at home involves putting ice on the fracture for the first week to reduce any swelling or inflammation. After the first week, heat can be used to prevent stiffness. It is also important for the patient to rest to allow the fracture to heal.
Pain from a vertebral compression fracture can be severe. The patient may experience a significant reduction in pain during bed rest due to the fact that standing and sitting puts weight on the vertebra and can cause pain. The patient should discuss pain management and medication choices with a physician. Any loss of feeling or function may indicate nerve damage and a physician should be consulted immediately
If left untreated, vertebral compression fractures usually heal in about 90 days. During this time, in addition to pain management and rest, the physician may recommend a back brace. The back brace should be worn while standing or sitting to provide extra support for the vertebrae.
There is a surgical option, known as kyphoplasty, which can be used to repair a vertebral compression fracture. This procedure involves inserting a balloon into the body of the vertebra to restore the height of the bone. Cement is then injected into the bone to stabilize the fracture. In a patient with osteoporosis, one risk with this procedure is that the newly opened vertebra will put pressure on the neighboring vertebra and cause another fracture.
Men and women who are susceptible to osteoporosis should have bone density screening done periodically. Patients with low bone density may be put on medication to slow the effects of osteoporosis. The physician may also recommend supplementing the diet with calcium and vitamin D. Weight bearing exercise has also been shown to strengthen bones. A combination of these activities may help prevent a painful vertebral compression fracture.