Vertebral Compression Fracture

A vertebral (ver-t-brull) compression (kum-preh-shun) fracture (frak-shur) is when one or more bones in your spine (back) break down. The spine is made up of 33 bones and runs down the middle of your back. These bones are called vertebrae (ver-tih-bray). It is also called a vertebral crush fracture.

Vertebral compression fracture, defined as a 15% to 20% reduction of anterior, posterior, or central vertebral body height, occurs in 25% of women over age 50, often after trivial injury (bending, lifting, cough, or sneeze). Risk factors include prolonged postmenopausal state, glucocorticoid use, smoking, alcohol abuse, arid medical diseases known to affect calcium or bone metabolism (e.g., renal failure). In patients less than age 60 prevalence is higher in men and is generally the result of trauma.

Causes

Some of the causes of a vertebral compression fracture.

• An injury such as a fall or jump.
• Osteoporosis or "brittle bone" disease. People with osteoporosis do not have to fall or injure themselves to get broken vertebrae.
• Lack of calcium and sustained use of some medicines can also lead to weaker bones. This makes it easier to get a vertebral compression fracture.

Symptoms

• Acute, severe pain at the fracture site is typical; however, minor fractures in elderly or postmenopausal patients may be asymptomatic.
• Pain may radiate anteriorly to the flank or abdomen and increase with movement or Valsalva.
• Radicular pain or symptoms of spinal cord compression (bilateral leg pain, paresthesias, incontinence) are very rare.
• Nausea and vomiting may be encountered due to an ileus.

Signs

• Spinal tenderness over fracture site
• Paravertebral muscle spasm
• Ileus (abdominal distention and decreased bowel sounds)
• Kyphosis and loss of height
• Weakness, sensory deficits, incontinence, or diminished deep tendon reflexes (spinal cord compression) +

Treatment

You may need an x-ray of the spine to determine the location of the injury. Casts and splints aren't used for this type of fracture, but you may need to wear a back support. Your doctor also will probably prescribe medication for the pain and drugs that will gradually strengthen the bones.

Prevention

Avoid heavy lifting and doing exercise.