A Comprehensive Guide to Understanding Compression Fractures
The spine is the central support system for the human body. It provides structure, stability, flexibility, and support to the body. It also protects the spinal cord, which acts as the channel of communication between the brain and the rest of the body.
The spine is composed of 33 bones, which are known as the vertebrae. Compression fractures are also known as spinal compression fractures. They occur when one or more vertebrae in the spine collapse or compress, resulting in small breaks in the vertebrae.
These breaks may occur due to weakening of the vertebrae due to injury, disease, osteoporosis, or any other medical condition. Compression fractures generally affect the thoracic and lumbar regions of the spine. However, they can occur in any part of the spine. Over time, if left untreated, they can result in flattening or collapse of the vertebrae.
Causes of compression fracture
Compression fractures arise due to various causes, ranging from underlying medical conditions to injuries. Some of the common causes of compression fractures are:
Osteoporosis
It is one of the most common causes of compression fractures.
The bone mineral loss from the vertebrae in this condition weakens the vertebrae.
This makes them crumble and collapse.
The weakened vertebrae become more vulnerable to compression fractures.
Osteoporosis is more commonly seen in women than men, especially after 60 years of age.
Trauma
Sports injuries, car accidents, or a fall may result in a heavy impact on the spine, thus causing compression fractures.
Tumors
Malignant or non-malignant tumors that may develop within or adjacent to the spine elevates the risk of compression fractures.
Infections
Spinal infections such as discitis or osteomyelitis may weaken the vertebrae resulting in compression fractures.
Metabolic conditions
Certain metabolic conditions can reduce the bone density and increase the risk of compression fractures. For example, hypoparathyroidism. Paget’s disease, etc.
Medications
Regular use of medications, especially corticosteroids, weaken the vertebrae, which may lead to compression fractures.
Medications prescribed for arthritis or autoimmune disease may greatly increase the risk.
Vertebral fractures
Fractures in the adjacent vertebrae may put pressure on the other vertebrae, thus leading to spinal compression fractures.
Degenerative disc disease
Due to aging, the intervertebral discs between the vertebrae degenerate.
This results in loss of cushion, and the ability to absorb shock and even distribution of pressure along the spine.
Risk Factors associated with compression fractures
Be it men or women, the risk of compression fractures increases with age. One of the most important risk factors for compression fractures is having osteoporosis or being at the risk of having it.
Here are some of the common risk factors for compression fractures.
More than 50 years of age
Women who are past menopause
Having osteoporosis
Having a medical history of cancer
Low bone density
Less body-mass index (BMI)
Vitamin D deficiency
Symptoms of compression fractures
The symptoms for compression fracture may vary depending on its severity and the cause of it. Here are some of the most common range of symptoms:
Mild or severe sudden sharp pain in the back that develops gradually
Muscle spasms
Abnormal spine curvature
Stooped posture
Difficulty in breathing
Limited movements and flexibility
Tenderness at fracture site
Numbness and tingling sensation
Loss of height with time
Difficulty in twisting or bending
Loss of bowel or bladder control
Most people do not have any symptoms or pain early on. It develops gradually with time. The most easily identifiable symptom of compression fracture is localized and constant back pain.
Types of compression fractures
There are three different types of compression fractures depending on how the vertebra breaks.
Wedge fracture
It usually occurs in front of the vertebrae.
The front-side of the bone collapses
Wedge-shaped vertebra is formed.
Spine curves over due to one or more wedge fractures.
Crush fracture
Entire bone breaks due to flattening or compression.
Burst fracture
More severe than other types.
It occurs due to a sudden blow.
Bone in the spine becomes heavily compressed and crushed.
Fragments from crushed vertebrae spread in all directions.
This may damage nerves in the spinal cord.
Diagnosis of compression fracture
The diagnosis of spinal compression fracture consists of a physical examination, review of medical history, family history, and condition, along with digital diagnostic tests.
The doctor initially performs a physical examination to check the area of the spine for tenderness, sensitivity, or deformity.
During the examination, the doctor also checks whether the spine is hunched forward or not, understands the cause of the pain, and helps eliminate the possibility of any other medical condition.
If the doctor suspects a compression fracture, additional diagnostic tests such as X-ray, MRI, CT scan, nuclear bone scan may be advised for confirming the fracture.
In case of osteoporosis, a bone density test (DEXA scan) may be recommended to know the bone strength and density.
Compression fractures treatment
The treatment of compression fractures depend on the severity of the fracture, cause, and the type of breakage.
The first line of therapy for compression fractures include the use of non-surgical methods.
This may include pain relieving anti-inflammatory medications, bracing, and physical therapy.
In case of severe pain, opioid medicines may be prescribed.
The compression fracture treatment focuses on pain relief and enabling people to move quickly as soon as possible.
Surgical treatment for compression fractures
If the pain is severe or still persists after non-surgical treatment for compression fractures, surgical treatment is then recommended.
Vertebroplasty
It is a minimally invasive surgical procedure.
The doctor injects acrylic bone cement into the collapsed bone.
This fixes the spine at its proper position.
It reduces the pain and bone deformity.
Kyphoplasty
It is a minimally invasive surgical procedure.
It involves inserting a small balloon in the affected area.
The balloon is expanded to restore the bone to its normal shape.
This is followed by injecting bone cement to stabilize the vertebrae.
Spinal fusion
It involves repairing the bone and permanently adhering the vertebrae together in a fixed position.
The compression fracture recovery time in most cases is usually 6-8 weeks. However, some fractures may even require almost 3-6 months.
Is frequent back and neck pain a cause of concern for you? Schedule an appointment with Chicago Neuro Pain today to evaluate whether you have a compression fracture or are at risk of osteoporosis.