FAQ’s on Vertebral Compression Fracture in Philadelphia

A vertebral compression fracture (VCF) occurs most often in the middle back region (thoracic spine). This condition is more common among older adults, and it causes loss of spinal mobility and pain.

Who gets VCFs?

Around 1.5 million people suffer from VCFs in America each year. Postmenopausal women make up 25% of these persons, and by age 80 years, 40% of women have a VCF. Studies show that the incidence of VCF is as high as 11 per 1,000 women and 6 per 1,000 men. In addition, Caucasian and Asian women are more likely to suffer this type of fracture.

What are the symptoms of vertebral compression fracture?

VCF causes serious back pain, significant disability, and functional limitations. In addition, a person with a VCF complains of back pain, which is worse with standing and walking. VCF can lead to progressive kyphosis of the spine, decreased lung function, loss of height, and spinal deformity.

What risk factors are associated with VCF?

The risk factors associated with vertebral compression fracture that are modifiable include tobacco abuse, alcohol consumption, and estrogen deficiency. However major risk factors that cannot be changed include:

  • Susceptibility to falls
  • Female gender
  • Being of Caucasian or Asian race
  • Advancing age
  • History of VCF in first-degree relative

What causes a vertebral compression fracture?

A VCF occurs when one of the spinal bones (vertebra) collapses from loss of bone density and fractures. This can occur anywhere along the spinal column, but is more likely to affect the thoracic spine. Osteoporosis is the most common type of VCF, but they also are caused by a hard fall, a sports injury, a car accident, or a tumor of the spine.

What are the complications associated with VCF?

  • Segmental instability – Vertebral compression fractures cause segmental instability, where a fracture causes the vertebral bod to collapse more than 50 percent. One section of the vertebra will deteriorate, which causes the impaired movement and pain.
  • Neurological deficit – The fracture may press on the spinal cord and nerves, causing tingling, numbness, weakness, and pain of the affected body part.
  • Spinal deformities – When one or more vertebrae collapse, it can lead to kyphosis (humpback) of the spine. This causes breathing problems, pain of the internal organs, and makes the spine appear rounded.

How are vertebral compression fractures treated?

The treatment of a VCF depends on the patient’s health, age of the patient, and willingness for the patient to participate in therapy. Options include:

  • Preventive measures – To prevent VCF, the doctor may prescribe a bone-strengthening agent, such as Fosamax, Actonel, or Boniva. These are used to restore bone loss and stabilize the fracture.

 

  • Bedrest and comfort measures – The doctor will advise the patient on bed rest and use of heat or cold packs for comfort. Over the counter anti-inflammatory agents are recommended, such as ibuprofen and naproxen. A back brace offers support to the spine and prevents motion of the fracture during initial recovery.

 

  • Medications – Prescription pain medicines are used to alleviate the discomfort associated with a compression fracture.

 

  • Bracing – there are braces that include the Jewett Brace, or possibly a TLSO type of brace that can help provide pain relief. The same way as a splint would provide relief for an extremity fracture.

 

  • Vertebroplasty and kyphoplasty – To restore bone height and correct a VCF, the doctor can perform a surgical procedure. Using x-ray guidance, a needle and probe is inserted into the collapsed bone, and cement is injected to fill the fracture. According to studies, these procedures have a 90% success rate.

Resources

Barr JD, Barr MS, Lemley TJ, McCann RM. Percutaneous vertebroplasty for pain relief and spinal stabilization. Spine (Phila Pa 1976) 2000 Apr 15;25(8):923–8.

Huang MH, Barrett-Connor E, Greendale GA, Kado DM. Hyperkyphotic posture and risk of future osteoporotic fractures: the Rancho Bernardo study. J Bone Miner Res. 2006 Mar;21(3):419–23.

Wardlaw D, Cummings SR, Van Meirhaeghe J, et al. (2009). Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial. Lancet, 373(9668):1016-24.