Vertebral Compression Fracture

Also Called: Osteoporotic fracture, wedge fracture, spinal compression fracture, collapsed vertebra.

What It Is

A compression fracture happens when a vertebra collapses, usually into a wedge shape with the front shorter than the back. Most are caused by osteoporosis. Osteoporosis thins the bone enough that everyday forces can break it — a cough, a sneeze, or bending to pick something up.

Causes & Risk Factors

Osteoporosis is by far the most common cause, and the risk climbs with age, after menopause, and with long-term steroid use. Less often, a compression fracture follows a harder impact, like a fall or car accident, in someone whose bones are otherwise healthy. It can also come from a bone weakened by illness instead of osteoporosis. For that reason, a new compression fracture is always worth a closer look.

Symptoms

• Sudden onset of sharp, localized back pain
• Pain that worsens with standing, walking, or changing position
• Some patients also notice a gradual forward lean or a loss of height over time

Diagnosis

A new compression fracture is usually clear on an X-ray. An MRI adds one thing the X-ray can't: whether the fracture is recent and still likely to respond to treatment, or already healed. That distinction decides whether kyphoplasty is an option.

Treatment

Pain from a compression fracture often improves on its own over six to eight weeks as the bone heals, and most fractures are initially managed with pain medication, a period of activity modification, and sometimes a brace. The underlying osteoporosis also needs treatment, since a first fracture increases the risk of another one.

Kyphoplasty is considered when pain has not improved with conservative care, and when imaging shows the fracture is still likely to respond to treatment. Waiting too long can close that window, which is why a new compression fracture is worth evaluating promptly.