Compression = the application of strong pressure
Fracture = a break in a bone
A compression fracture occurs when part of a vertebra, or bone in the spine, collapses.
The bones of the spine have two main section. 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 bodyis 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.
The most common type of compression fracture is a wedge fracture, in which the front of the vertebral body collapses but the back does not, meaning that the bone assumes a wedge shape.
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.
Compression fractures usually occur in the thoracic (middle) or lumbar (lower) spine.
Symptoms
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)
- over an extended period, 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.
Causes and Risk Factors
Rarely, compression fractures occur in healthy vertebrae as a result of trauma.
More often, the vertebra with a compression fracture is already weakened. The most common cause of weakening is osteoporosis, a condition that causes weak and brittle bones. Osteoporosis is most common in elderly women, and it is for this reason that elderly women are the group most affected by compression fracture.
Less frequently, the vertebra may be weakened by a tumor or infection.
Treatments
For the most part, nonoperative treatments are recommended for compression fracture.
At Alimran Medical Center, we may recommend any of the following treatments:
Chiropractic
Steroid injection
- Trigger point injections
- Epidural steroid injections
- Transforaminal injections
Ozone injection
Prolotherapy
Spinal cord stimulation
If the fracture is caused by osteoporosis, treatment of the osteoporosis can help prevent additional fractures. Treatment may include calcium and vitamin D supplements, bisphosphonates, and weight bearing exercises.
Surgery may be necessary if the spine appears to be unstable. The surgeon may perform a vertebroplasty or a kyphoplasty. During these surgical procedures, the surgeon injects a cement mixture into the fractured bone to stabilize the fracture, treat pain, and prevent a spinal deformity from progressing.
In some cases, the surgeon may need to perform a spinal stabilization and fusion surgery to support the spine until the bone heals. During these procedures, the surgeon places a bone graft across the area of instability, allowing the vertebrae to fuse (grow together). The surgeon secures the spine with an internal fixation implant, using screws and rods, to hold the vertebrae in place while the bone heals.
The surgeon will tailor the treatment to each individual patient and specific presentation.