Vertebral Compression Fracture

The spine is made up of strong bones called vertebrae. A vertebra can break just like any other bone in the body. When the vertebral body collapses, it is called a vertebral compression fracture. These fractures happen most commonly in the thoracic spine (the middle portion of the spine), particularly in the lower part. Vertebral fractures are usually caused by a condition such as osteoporosis, a very hard fall, or another type of injury.

What Causes a Compression Fracture?

Compression fractures of the spine generally occur from too much pressure on the vertebral body. The fracture occurs when the vertebral body collapses, causing the front part of the vertebral body to become wedge-shaped. The bone tissue on the inside of the vertebral body is crushed, or compressed.

A compression fracture can happen when the spine bends forward at the same time downward pressure builds on the spine. For example, falling to the floor in a sitting position causes the spine to bend and the head to be thrust forward. This position, combined with pressure on the buttocks, concentrates stress on the front part of the spine, the vertebral bodies.

There are several causes of compression fractures.

• Vertebral WeaknessIf the vertebra is too weak to withstand normal stress, it may take very little pressure to cause it to collapse. Most healthy bones can withstand stress, and the spine is able to absorb the shock. However, if the forces are too high, one or more vertebrae may fracture.

• OsteoporosisOsteoporosis is a common cause of compression fractures in the spine. This disease thins bones, often to the point where they become too weak to bear normal pressure. They can eventually collapse during normal activity, leading to a spinal compression fracture. Spinal compression fracture is the most common type of fracture from osteoporosis. Forty percent of all women will have at least one spinal compression fracture by the time they turn 80 years old.

  In severe cases of osteoporosis, actions as simple as bending forward can be enough to cause a “crush fracture,” which can lead to loss of body height and a humped back (kyphosis), especially in elderly women.

• TraumaCompression fractures due to trauma can come from a fall, a forceful jump, a car accident, or any event that stresses the spine past its breaking point.

• CancerCancer that spreads to the spine weakens its ability to support the body and withstand normal stresses. The bones of the spine are a common place for many types of cancers to spread. The cancer may destroy part of the vertebra, weakening the bone until it collapses.

Symptoms of Compression Fracture

If a spinal fracture is caused by a sudden, forceful injury, you will probably feel severe pain in your back, legs, and arms. You might also feel weakness or numbness if the fracture injures the nerves of the spine.

If the bone collapse is gradual, such as a fracture from osteoporosis, the pain will usually be milder. There might not be any pain at all until the bone actually breaks.

In very severe compression fractures, parts of the back of the vertebral body may actually protrude into the spinal canal and put pressure on the spinal cord. Fortunately this is not a common occurrence.

Treatment options include:

Vertebroplasty – a minimally invasive procedure that involves injecting a medical-grade cement mixture into the empty spaces within the weakened vertebrae to repair the bone, strengthening it and provide pain relief.

Kyphoplasty – a similar procedure to vertebroplasty, which is used when the bone has collapsed to the point that there is no empty space to inject the cement. A balloon is first inserted into the fractured vertebra and inflated to create space, then the balloon is removed and the cement is injected.

Source: DePuy Spine, Inc.