What it is
A compression fracture is a collapse of the vertebral body, most often in thin bone from osteoporosis, sometimes after minor trauma that would not have broken a healthy spine, and occasionally because the bone has been weakened by a tumor or infection.
Treating the fracture is only half the problem. The other half is why the bone broke, and that part is frequently left undone.
Symptoms
- Sudden back pain, often starting with a cough, a lift or a minor stumble
- Pain sharply worse with standing and walking, better lying flat
- Loss of height, or an increasing forward stoop over successive fractures
- Localised tenderness over one spot on the spine
How it is diagnosed
X-rays show the collapse. MRI distinguishes a recent fracture that is still healing from an old one, which decides whether a procedure could help. Where the appearance is atypical, Dr. Long will look specifically for tumor or infection rather than assume osteoporosis. Bone density testing belongs in the workup of almost every one of these.
Non-surgical treatment
Most fractures heal. Pain control, a brace in some cases, early mobilization to avoid deconditioning, and physical therapy as the pain allows. Alongside that: assessment and treatment of the osteoporosis itself, which is what prevents the next fracture.
When surgery is considered
Where pain remains severe and disabling despite several weeks of appropriate treatment, or where the fracture is progressively collapsing. Kyphoplasty stabilizes the fractured body with cement through a small needle and often relieves pain quickly. Fractures with neurological compromise, or those caused by tumor or infection, are treated differently and more extensively.