Fractured vertebrae
Fractured vertebrae are broken bones in the spinal column that occur due to trauma or disease, such as osteoporosis. Vertebral compression fractures (VCFs) are typically caused by osteoporosis, which weakens bones over time. A VCF can occur when the front of a vertebra splits and crumbles, often due to the intense force caused by a fall.
Symptoms
- Difficulty bending or twisting
- Hunching over
- Intense pain, especially in the middle or low back
- Loss of height
- Pain that worsens with movement but improves or disappears at rest
Prevention
Take steps to prevent osteoporosis, which causes most spinal fractures. Patients can:
- Avoid smoking.
- Eat foods containing calcium and vitamin D, which promote healthy bones.
- Perform weight-bearing exercises, which strengthen bones.
- Take calcium and vitamin D supplements.
Risk factors
- Osteoporosis
- Personal history of VCF due to osteoporosis
- Spinal tumors
- Trauma
Diagnosis
- Medical history. Discuss with a healthcare any symptoms, medical conditions present and medications taken.
- Physical examination. The physician will look for any abnormalities in your posture or the curvature of your spine and may apply gentle pressure to different areas of your back to determine the source of discomfort. Testing reflexes will help assess whether nerves are involved.
- Imaging tests. An X-ray can confirm the diagnosis of a VCF, and an MRI or a CT scan reveal the extent of a fracture and damage to surrounding structures. If osteoporosis likely caused the VCF, a dual-energy X-ray absorptiometry scan, which measures bone density, may be ordered.
Treatment
- Rest and pain management. Limiting activity and taking medication to control pain help most cases of VCF heal in a few months. A brace may be necessary to limit movement during the healing process.
- Surgery. If conservative treatment does not provide relief or the patient has severe pain, surgery may be necessary to shore up the vertebra. One surgical option is kyphoplasty, in which the surgeon inflates a balloon inside the vertebra to create a space and then fills it with cement to stabilize the vertebra. In another option, vertebroplasty, the surgeon injects cement into the vertebra without using a balloon to create a cavity.
Follow-up care
- As the spine heals, patients should avoid vigorous exercise and heavy lifting.
- Follow physician instructions regarding medication use, pain management and when to resume activities.
- Patients may need to wear a brace for several weeks, as directed by the physician.