Spinal compression fracture

Spinal compression fractures, also known as compression fractures, happen when one or more vertebrae in the spine compress or collapse. Reasons for this compression may include injury, osteoporosis or other medical conditions.

Spinal compression fractures typically impact the thoracic (middle back) and lumbar (lower back) regions, but they can happen in any part of the spine.

Left untreated, these fractures can cause severe back pain, restrict movement and even lead to spinal deformities in severe cases.

Causes of spinal compression fractures

Spinal compression fractures can arise from various factors, ranging from injuries to underlying medical issues. Here are some common causes:

• Degenerative disc disease: Over time, the intervertebral discs between the vertebrae may degenerate, losing the ability to absorb shock and distribute pressure evenly along the spine.
• Metabolic conditions: Metabolic disorders, such as Paget's disease or hyperparathyroidism, can reduce the density of the bones and increase the risk of compression fractures.
• Medications: Prolonged use of corticosteroid medications, which are commonly prescribed for conditions such as arthritis or autoimmune disorders, can make the bones weaker and lead to compression fractures.
• Osteoporosis: This is the most common cause of spinal compression fractures. This condition weakens bones, making them more vulnerable.
• Spinal Infections: Infections such as osteomyelitis (infection of the bone) or discitis (infection of the intervertebral discs) can weaken vertebrae and lead to fractures.
• Spinal tumors: Cancerous or non-cancerous tumors that develop within or adjacent to the spine may increase the risk of a spinal compression fracture.
• Trauma: High-impact accidents such as car accidents or sports injuries can lead to heavy impact on the spine, causing compression fractures.
• Vertebral fractures: Fractures in adjacent vertebrae place stress on other vertebrae and potentially lead to spinal compression fractures.

If you’re at risk of a spinal compression fracture, you should adopt proactive measures to maintain spinal health, including regular exercise, getting enough calcium and vitamin D in your diet and lifestyle adjustments to reduce the risk of falls and trauma.

Spinal compression fracture symptoms

If you have a spinal compression fracture, you may have various symptoms depending on how severe your fracture is and what caused it. Common symptoms include:

• An abnormal curvature of the spine (kyphosis)
• Back pain
• Difficulty breathing
• Limited mobility
• Loss of height
• Muscle spasms
• Neurological symptoms such as numbness, tingling, weakness or loss of bowel or bladder control
• Radiating pain to other areas of the body, such as the abdomen, hips or legs

Persistent, localized back pain is often the most noticeable symptom of a spinal compression fracture. The pain may worsen with any type of movement, even with simple activities like coughing or sneezing.

It's essential to make an appointment with your provider if you experience any of these symptoms, especially if your pain is persistent or severe. Early diagnosis and treatment can help alleviate pain, prevent further complications and improve overall outcomes.

Diagnosing spinal compression fractures

Diagnosing a spinal compression fracture involves a combination of a physical exam, reviewing your medical history and digital imaging testing. Other testing, such as blood tests and a lumbar puncture, may be used to look for underlying medical conditions.

During the physical examination, your provider will check your spine for tenderness, range of motion or any deformities. They may also perform neurological tests to evaluate sensation, strength and reflexes in the arms and legs.

X-rays are used to evaluate the spine and look for any spinal fractures. This is usually the first imaging test your provider will use. MRI and CT scans are often utilized to confirm a fracture and to provide detailed images of the spinal cord.

In cases where osteoporosis is the underlying cause of a spinal compression fracture, bone density testing (DEXA scan) may be performed to check bone density and strength.

Spinal compression fracture treatment

Spinal compression fractures treatment depends on how severe your fracture is. Your provider may begin treatment with nonsurgical options, including rest and over-the-counter pain medication such as ibuprofen or naproxen. If your pain is severe, they may prescribe opioid medications to manage pain.

Back braces and other devices can help provide support to the spine and relieve some pain during the healing process.

Your provider may recommend a orthopedic physical therapy program to improve strength, flexibility and posture. Strengthening the muscles surrounding the spine, particularly the core region, can provide additional stability to the injured area.

Surgical treatment options

If your condition is severe or persistent, you may need surgery and will be referred to an orthopedic surgeon. Surgical options may include:

• Vertebroplasty: Your surgeon injects a medical-grade substance called bone cement, which “glues” the spine in its proper position to reduce pain and bone deformity.
• Kyphoplasty: A balloon is inserted into the affected area to decompress your spine and allow you to regain lost height. Then your surgeon will inject bone cement to stabilize your vertebrae.
• Spinal fusion: An orthopedic surgeon will permanently adhere your vertebrae together in a fixed position.
• The choice of treatment depends on various factors such as the underlying cause, level of pain and severity of the fracture.

Complications of a spinal compression fracture

Spinal compression fractures can lead to long-term complications, which may include:

• Chronic pain
• Dependency on pain medications
• Increased risk of additional fractures
• Long-term limited mobility
• Loss of height
• Spinal deformity, such as kyphosis (excessive rounding of the upper back) or scoliosis (sideways curvature of the spine)
• Weakness, numbness, tingling or loss of bowel or bladder control