Vertebral Compression Fractures

With an estimate of over 10 million Americans suffering from osteoporosis, 8 million of the affected total are women. There are an additional 34 million at risk of developing osteoporosis due to low bone mass. This increased chance also makes them more prone to (VCFs) vertebral compression fractures.

What are Vertebral Compression Fractures (VCFs)? 

Affecting an estimated 750,000 Americans annually, vertebral compression fractures are considered the most common type of fracture in osteoporosis patients. 25% of postmenopausal women suffer from VCFs. The prevalence of vertebral compression fractures increase with age. Women over the age of 80 that are affected can be as high as 50% in the United States. This condition is less common in men, but does pose a major health concern for those more advanced in age.

Severe pain, deformity, and a loss in height can be the result when a vertebral body collapses in the spine. The most common place for these fractures is in the thoracic (or middle) spine. If the patient has sustained a previous osteoporotic VCF, they are more susceptible to another by 20%. Symptoms are not always present, or may be minor. This does not eliminate risk.

What Causes Vertebral Compression Fractures?

A vertebral compression fracture can be caused by trauma or metastatic tumors, with the most common cause being osteoporosis. In healthy patients, the causes can be sports injuries, a dramatic fall, or vehicular accident. A forceful trauma or lifting a heavy object can cause a VCF with moderate cases. In more advanced cases of osteoporosis, a vertebral compression fracture can be the result of everyday daily activity, such as sneezing or lifting an object.

If a patient is young and healthy with no history containing trauma, the most common cause would be metastatic tumors. Many cancers can spread in the bones of the spine causing destruction and weakness in parts of the vertebrae, resulting in collapse (Clinical outcome and safety of multilevel vertebroplasty: clinical experience and results 2014).

How is VCF Diagnosed?

• x-ray
• MRI
• CT or CAT scan ( computed tomography scan)
• DXA or DEXA (dual energy x-ray absorptiometry)
• Bone densitometry
• Neurological complications
• Instability of the spine
• kyphosis

What Complications can be Related to Vertebral Compression Fractures?

• Neurologic Complications – unusual
• Spinal Instability – also unusual
• Kyphosis – common with several fractures where the person ends up hunched forward.

What are the Symptoms of VCF?

Symptoms of vertebral compression fractures may include:

• Acute sudden back pain
• Pain increases while standing or walking
• Lying on the back decreases pain
• Restricted or limited spinal mobility
• Loss in height
• Progressive deformity
• Progressive disability
• Having said that – a lot of patients have NO pain at all

How do you Treat Vertebral Compression Fractures?

In a traditional treatment plan, patients suffering with painful symptoms have been treated with conservative methods. Vertebral instability from the site of the fracture can be the main cause of acute pain. Generally it can be up to three months to heal naturally. Acute pain symptoms, on average, increase significantly in 7 to 10 days. Restricted activity and bed rest may be the best treatment initially.

• NSAIDS, acetaminophen, and ibuprofen
• For more severe pain, pain medication (narcotic and muscle relaxants) may be prescribed short-term
• Bracing therapy bracing may be used to provide external support, restrict motion, and reduce pain
• Bisphosphonates bone strengthening drugs to prevent further fracture

If the patient is not responding adequately to conservative treatments, there are two minimally invasive procedures may be considered as options (Comparative analysis of vertebroplasty and kyphoplasty for osteoporotic vertebral compression fractures 2014):

• Vertebroplasty pain relief has been effectively achieved by using a therapeutic hardening cement to strengthen and stabilize the fractured vertebrae. This adds mechanical support and overall stability.
• Kyphoplasty this technique is newer and enhances the previous with the benefit of restorative height to the spine. Two balloons are inserted opening a longer channel for the cement to fill.

What are the Risks of VCFs?

As with every surgery there is no guarantee of 100% success. Rates of complication for invasive VCF surgery are less than 2% for osteoporotic patients, and less than 10% or a tumor related procedures

Premier Pain & Spine has Board Certified Chicago pain management doctors who offer both vertebroplasty and kyphoplasty for VCF’s. Most insurance is accepted and appointments are readily available to help provide the best treatment possible at our Chicago area locations!