Back Fracture

Overview

Definition

A vertebral fracture is a break in one of the bones of the spine. This type of fracture usually occurs when the front part of the bone is squeezed or compressed. They are most common in the bones at the chest level.

Vertebral Fracture
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Causes

A vertebral compression fracture can be caused by:

  • Weakening of the bone because of conditions like:
    • Osteoporosis—decreased bone mass and density
    • Bone infection
    • Bone cancer
  • A direct blow to the back
  • Falling down
  • Landing on your heels when jumping from a height
  • Having major trauma such as a motor vehicle accident

Risk Factors

Factors that may increase your chances of vertebral compression fractures:

  • Osteoporosis
  • Previous vertebral fracture within the last year
  • Female gender
  • Older age
  • Trauma
  • Cancer
  • Chronic use of corticosteroids
  • Proton pump inhibitors
  • Poor mental functioning
  • Poor mobility
  • Poor strength

SymptomsandDiagnosis

Symptoms

Most people do not have symptoms. If present, symptoms may include:

  • Mild to severe pain in the middle or lower back
  • Numbness, tingling, or weakness
  • Difficulty walking

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.

Images may be taken of your bodily structures. This can be done with:

  • X-rays
  • MRI scan
  • CT scan
  • Bone scan

You may be tested to look for signs of osteoporosis. This can be done with a bone mineral density test.

Treatments

Treatment

The goal of treatment is to allow the bone to heal. Options will depend on the severity of the fracture and your overall health but may include:

Nonsurgical Treatments

Your doctor may advise:

  • A brief period of bed rest and a decrease in activity
  • Medication to control the pain
  • Strengthening exercises for your back muscles
  • A back brace

Surgery

More severe fractures may require:

  • Vertebroplasty—Liquid cement is injected into the bone to help relieve the pain. It may be best for recent fractures. It may not be as helpful in people whose fractures are due to osteoporosis.
  • Kyphoplasty—A balloon or other procedure is used to create a small space in the bone near the fracture. The cement is injected into the cavity. This procedure is designed to relieve pain. It can also improve spinal deformities from the fractures.
  • Spinal fusion—Joins together two or more bones in the spine. It is most often used for burst fractures. This procedure stops the bones from moving.

Your doctor may also start treatment for related factors. For example, you may be given a program to help slow bone loss from osteoporosis.

Prevention

Building strong bones will help prevent more fractures. Steps for healthy bones include:

  • Get plenty of weight-bearing exercise. This includes walking, jogging, or sports such as tennis.
  • Do strength exercises for arms and legs. This will help to improve your bones but also improve balance to decrease falls.
  • Get plenty of calcium, vitamin D, and protein in your diet. Talk to your doctor if you think you need supplements.
  • If you have osteoporosis, you should talk to your doctor about treatment options. If you had an early menopause, talk to your doctor about this.
  • If you smoke, talk to your doctor about ways to quit.
  • Drink alcohol only in moderation. Moderate alcohol intake is 2 drinks per day for men and 1 drink per day for women.

Lowering the risk of falls can also decrease your risk of fractures. Remove any obstacles in your home that could cause you to fall. These may include throw rugs or furniture.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.

a (Fracture, Vertebral Compression)

RESOURCES

National Institutes of Arthritis and Musculoskeletal and Skin Diseases https://www.niams.nih.gov 

National Osteoporosis Foundation https://www.nof.org 

CANADIAN RESOURCES

Canadian Orthopaedic Association http://coa-aco.org 

Women's College Hospital—Women's Health Matters http://www.womenshealthmatters.ca 

References

Bone basics. National Institutes of Arthritis and Musculoskeletal and Skin Diseases website. Available at: https://www.bones.nih.gov/health-info/bone/bone-basics. Accessed December 19, 2017.

Committee on Practice Bulletins-Gynecology, The American Congress of Obstetricians and Gynecologists. ACOG Practice bulletin 129. Osteoporosis. Obstet Gynecol. 2012;120(3):718-734. Reaffirmed 2016.

Osteoporosis. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T113815/Osteoporosis . Updated September 11, 2017. Accessed December 19, 2017.

Thoracolumbar vertebral compression fracture. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T114371/Thoracolumbar-vertebral-compression-fracture . Updated September 16, 2016. Accessed December 19, 2017.

Vertebral compression fractures. American Association of Neurological Surgeons website. Available at: http://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Vertebral-Compression-Fractures. Accessed December 19, 2017.

Vertebroplasty and kyphoplasty. Radiology Info—Radiological Society of North America website. Available at: https://www.radiologyinfo.org/en/info.cfm?pg=vertebro. Updated January 23, 2017. Accessed December 19, 2017.

12/19/2017 DynaMed Plus Systematic Literature Surveillance  http://www.dynamed.com/topics/dmp~AN~T114371/Thoracolumbar-vertebral-compression-fracture : Buchbinder R, Golmohammadi K, Joshnston RV, et al. Percutaneous vertebroplasty for osteoporotic vertebral compression fracture. Cochrane Database Syst Rev. 2015;(4):CD006349.