Types of Compression Fractures
- A vertebral compression fracture occurs when part of an individual bone of the spine (vertebra) becomes compressed. Vertebral compression fractures can be caused by osteoporosis, trauma, and diseases affecting bone. The bones of the spine have two main sections. The vertebral arch is a ring-shaped section that forms the roof of the spinal canal and protects the spinal cord. You can feel the spinous process, a projection from this arch, when you press on the skin in the middle of your back. The vertebral body is the cylindrical shaped portion of the vertebral one that lies in front and provides the majority of structural support. In a compression fracture, the vertebral body collapses. Sometimes, more than one vertebra fractures, a condition called multiple compression fractures. Multiple compression fractures can lead to kyphosis, a spinal deformity when the upper back curves forward, creating the appearance of a hunchback. In some cases, a person who experiences multiple compression fractures may notice a loss of height.
- Injury severe enough to cause a vertebra to break can occur with a fall from a tall height in which the person lands on his or her feet or buttocks. It can also occur in a person involved in a car accident. Usually the trauma necessary to break the bones of the spine is quite substantial. In certain circumstances, such as in elderly people and in people with cancer or who have osteoporosis, these same bones can be fragile and can break with little or no force. The vertebrae most commonly broken are those in the lower back, but they may break in any portion of the spine.
- Osteoporosis is a disease of bone in which bone density is reduced, which may increase the chance that a person could sustain a vertebral compression fracture with little or no trauma. Osteoporosis most commonly occurs in women who have completed menopause, but it can also occur in elderly men and in people who have had long-term use of a steroid medication such as prednisone.
- Pathologic fracture is a fracture occurring in the vertebra due to preexisting disease at the fracture site. Most commonly, this type of break is from cancer in the bone, which has often traveled from other sites in the body (called metastasis), such as from the prostate, breast, or lungs. Pathologic fracture can also occur with other diseases, such as Paget’s disease of bone and infection of bone (osteomyelitis).
Compression fractures may or may not cause symptoms. If compression fractures cause symptoms these may include; pain in back, arms, or legs, numbness and/or weakness in arms or legs (if the fracture has affected the spinal cord and/or surrounding nerves in the spine), and over an extended period some patients may notice a loss of height. A compression fracture that occurs suddenly can be very painful, but a compression fracture that occurs gradually may cause pain only gradually. Losing control (incontinence) of urine or stool or inability to urinate (urinary retention) are also possible symptoms and if these are present, the fracture may be pushing on the spinal cord itself.
A provider should evaluate back pain in certain situations and these include; in any elderly person, in a person with cancer, in anyone whose pain is exactly the same at rest as it is during activity, if pain while sleeping is worse than when awake, and in a child under 12 years of age. The provider may order X-rays, MRI of the spine, and/or a CT scan.
For the most part, nonoperative treatments are recommended for compression fracture. These treatments include pain medications, rest, ice, heat, and modified physical activity that includes a stretching and strengthening program directed by a physical therapist.
If you have any of these symptoms or are experiencing back pain, call 808-488-5555 for an evaluation today!