Compression Fracture

• A compression fracture involves the collapse of a vertebra, commonly caused by osteoporosis or trauma.
• Symptoms typically include sudden back pain, loss of height, and a stooped posture.
• Osteoporosis is a primary risk factor, especially in older adults, weakening bones and making them prone to fractures.
• Treatment ranges from conservative methods like pain management and bracing to surgical interventions such as vertebroplasty or kyphoplasty.
• Recovery time varies significantly based on the severity of the fracture and the chosen treatment approach.

What is a Compression Fracture?

A compression fracture refers to a type of break in a vertebra, one of the bones that make up the spinal column. This fracture occurs when the vertebral body collapses, becoming shorter in the front than in the back, or collapsing entirely. The spine is designed to support the body’s weight and protect the spinal cord, and when a vertebra fractures, its ability to perform these functions is compromised. These fractures are most common in the thoracic (mid-back) and lumbar (lower back) regions of the spine.

While severe trauma, such as a fall from a height or a car accident, can cause these fractures in individuals of any age, they are particularly prevalent among older adults with osteoporosis. According to the American Academy of Orthopaedic Surgeons, approximately 700,000 vertebral compression fractures occur annually in the United States, with a significant portion linked to osteoporosis.

Symptoms and Causes of Spinal Compression Fractures

The presentation of compression fracture symptoms causes can vary widely depending on the severity of the fracture and its underlying cause. Many individuals experience sudden, sharp back pain that worsens with movement, standing, or walking, and may improve with rest. Other common symptoms include:

• Sudden onset of back pain, often localized to the fracture site.
• Pain that radiates to the abdomen or sides.
• Loss of height over time.
• Development of a stooped posture (kyphosis), sometimes referred to as a “dowager’s hump.”
• Limited spinal mobility.
• In rare severe cases, neurological symptoms like numbness, tingling, or weakness if the fracture impacts the spinal cord or nerves.

The primary cause of spinal compression fractures in older adults is osteoporosis, a condition characterized by progressive bone density loss, making bones brittle and susceptible to fractures even from minor stress. Other causes include:

• **Trauma:** High-impact injuries from falls, sports accidents, or motor vehicle collisions can cause fractures in healthy bones.
• **Metastatic Tumors:** Cancers that spread to the spine can weaken the vertebrae, making them prone to collapse.
• **Other Medical Conditions:** Certain conditions like Paget’s disease, multiple myeloma, or long-term corticosteroid use can also compromise bone strength.

Compression Fracture Treatment and Recovery Time

Effective spinal compression fracture treatment aims to alleviate pain, stabilize the spine, and prevent further fractures. Treatment approaches are tailored to the individual’s condition, the severity of the fracture, and overall health. Conservative management is often the first line of treatment and may include:

• **Pain Management:** Over-the-counter pain relievers, prescription medications, or nerve blocks to control pain.
• **Rest:** Limited activity to allow the fracture to heal, though prolonged bed rest is generally discouraged.
• **Bracing:** A back brace can provide external support, reduce pain, and limit spinal movement during healing.
• **Physical Therapy:** Exercises to strengthen back muscles, improve posture, and enhance mobility once initial pain subsides.

For fractures that do not heal with conservative methods, or for severe pain, surgical options may be considered. These include vertebroplasty and kyphoplasty, minimally invasive procedures where bone cement is injected into the fractured vertebra to stabilize it. Vertebroplasty involves injecting cement directly, while kyphoplasty first uses a balloon to restore vertebral height before cement injection.

The compression fracture recovery time varies significantly, ranging from a few weeks to several months. Most individuals experience substantial pain relief within 2-3 months with conservative treatment. Surgical interventions typically offer quicker pain relief, often within days or weeks, but full recovery and return to normal activities can still take several months. Factors influencing recovery include the patient’s age, overall health, the presence of osteoporosis, the number of fractured vertebrae, and adherence to rehabilitation protocols. Long-term management often involves addressing the underlying cause, such as osteoporosis, through medication and lifestyle changes to prevent future fractures.