How do compression fractures happen

When conservative treatment options have proven ineffective, two minimally invasive procedures, called vertebroplasty and kyphoplasty, may be considered as treatment options.

Recent advances in spinal procedures have reduced the need for invasive surgery in many cases. Vertebroplasty for the treatment of VCFs was introduced in the U. The procedure is usually done on an outpatient basis, although some patients stay in the hospital overnight.

Vertebroplasty takes from one to two hours to perform, depending on the number of vertebrae being treated. The procedure may be performed with a local anesthetic and intravenous IV sedation or general anesthesia. Using x-ray guidance, a small needle containing specially formulated acrylic bone cement is injected into the collapsed vertebra. The cement hardens within minutes, strengthening and stabilizing the fractured vertebra.

Most experts believe that pain relief is achieved through mechanical support and stability provided by the bone cement. Kyphoplasty is a modification of this technique where a balloon is used to help guide the cement and to increase the height of the collapsed bone. The spaces created by the balloons are then filled with the cement. Patients with the following criteria may be considered candidates for vertebroplasty or kyphoplasty:. Patients with any of the following criteria should not undergo these procedures:.

The benefits of surgery should always be weighed carefully against its risks. The injured part hurts especially when it is About two thirds of the people with compression fractures due to osteoporosis do not have any symptoms. They feel no pain when the fracture occurs. People may become shorter and the back may become rounded called kyphosis or sometimes a dowager's hump when several backbones fracture. People may be unable to stand up straight. They may have difficulty bending, reaching, lifting, climbing stairs, and walking.

Sometimes a compression fracture causes sudden, sharp pain in the back or pain that develops gradually. The pain may be mild or very severe.

It may be constant and dull and may worsen when people stand, walk, bend forward, or sit for a long time. The pain may radiate to the abdomen. Gently tapping along the back, as doctors do during the examination, causes discomfort. Compression fractures that do not result from osteoporosis cause sudden pain, and the site of the fracture is tender to the touch.

These people usually also have muscle spasms. In many older people, the back becomes rounded and bent sometimes called a dowager's hump because they have had many vertebral compression fractures.

Rarely, the spinal cord or spinal nerve roots which pass through the spaces between the back bones are injured. This injury is more likely when the compression fracture results from great force, as occurs in a motor vehicle crash or a fall from a great height. Spinal cord injuries can cause numbness and loss of sensation, weakness in the legs, and paralysis see figure Where Is the Spinal Cord Damaged? Where Is the Spinal Cord Damaged? A spinal cord tumor is a noncancerous benign or cancerous malignant growth in or around the spinal cord.

People may have weak muscles, lose sensation in particular areas of the body, or People may become unable to control urination or bowel movements become incontinent. Spinal nerve root injuries are usually much less serious. They tend to cause pain that radiates to the leg, and they sometimes cause slight weakness of one leg or foot.

Doctors suspect compression fractures based on symptoms. They then do a physical examination. They gently tap along the middle of the back to see if pain results. Most compression fractures linked to osteoporosis are found in women, especially after menopause.

But older men develop osteoporosis and compression fractures, too. People who have had one compression fracture related to osteoporosis are at a higher than average risk of having another one.

When compression fractures first start developing, they may not cause symptoms. A healthcare provider may discover them on an X-ray that you had done for other reasons. Later symptoms may include:. If the fracture happens rapidly, you may feel sudden, severe, disabling back pain. Your healthcare provider will talk with you about your health history and recent injuries, and do a physical exam. They will check to see where you have pain and whether your upper spine is hunched forward.

If your healthcare provider suspects osteoporosis, you may need a bone density scan. These tests show if osteoporosis is the cause of the fracture. If your compression fracture is related to osteoporosis, your healthcare provider will want to treat the osteoporosis. You may need to take bone-strengthening medicine and calcium and vitamin D supplements. Physical therapy and exercises may be recommended, too. These things help make your bones stronger and can help prevent other fractures.

Different types of surgery are available and may be needed if other treatments aren't helping:. If a cancerous tumor is causing your symptoms, you may need radiation therapy as well as surgery to remove some of the bone and treat the tumor. If an injury has caused the fracture, you may need surgery to repair the bone and join vertebrae together.

This is a procedure called fusion. Preventing osteoporosis, or treating it if you have it, is the best way to help prevent compression fractures. Talk with your healthcare provider about a bone density test to see if you are at risk for osteoporosis, and then find out what you can do about it. Doing weight-bearing exercises to strengthen your muscles and bones, and balance exercises to reduce your risk of falling are important, too.

If you have osteoporosis and want to start an exercise program, check with your osteoporosis specialist first. Exercise is critical to overall health. But you may need to not do certain exercises or change them. Intravenous Pyelogram IVP.

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