How Serious Are Spine Compression Fractures?

Also known as vertebral compression fractures, spine compression fractures may be caused by actions that put increased force on the spine, such as lifting a heavy object or falling, in combination with weakened bone (osteopenia or osteoporosis).

“Bones tend to weaken with age, and conditions, such as osteoporosis, which causes bones to become brittle and weak, increase the risk of spine compression fractures,” says Robert Eastlack, MD, an orthopedic surgeon and head of spine surgery at Scripps Clinic. “If the bones are already weakened, something as simple as a sneeze or cough can result in vertebrae collapsing.”

Osteoporosis is more common in women than men, and so are spine compression fractures; they affect an estimated 40% of women age 80 and older.

Most spine compression fractures occur in the thoracic spine, which is the middle section of the spine. Small fractures may cause no symptoms or minor discomfort, but most fractures cause one or more of the following symptoms:

• Sudden back pain
• Back pain that worsens while standing or walking
• Limited mobility of the spine
• Loss of height over time
• Hunched posture over time

To diagnose a compression fracture of the spine, your doctor may use X-rays or other imaging tests such as MRI or CT scan. These tests also can help determine the best course of treatment.

Some spine compression fractures heal on their own with rest and time. Natural healing can take up to three months.

Over-the-counter pain medications, such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) can help with pain relief. If needed, your doctor may prescribe muscle relaxants or stronger pain medications. Additionally, a back brace may provide support and limit spinal movement while the fractured vertebrae heal.

If conservative treatments do not provide relief within six to eight weeks, or if the pain is severe and refractory to management with these modalities during that period of time, it may be time to consider surgery.

Kyphoplasty is a minimally invasive surgical procedure that repairs the fractured vertebra using a special type of bone cement.

“Guided by real-time X-ray images, we use a small needle to pass a balloon into the fracture to help restore the height of the collapsed bone, then inject the cement into the space created by the balloon,” says Dr. Eastlack. “In just a few minutes, the cement hardens, strengthening and stabilizing the bone to prevent it from collapsing again.”

Also called balloon kyphoplasty, the procedure may be performed under local or general anesthesia. If local anesthesia is used, you will be awake during the surgery but will not feel pain, whereas you will be asleep during general anesthesia.

Kyphoplasty is generally safe, but like any type of surgery, it does have risks. These include bleeding, infection and anesthesia-related problems. Although rare, bone cement can also leak out of the bone and result in nerve aggravation or injury. Talk with your doctor about the risks and benefits of kyphoplasty to determine if it is the right treatment for you.

Your doctor can measure the strength or density of your bones using a dual-energy X-ray absorptiometry (DXA or DEXA) or bone densitometry test. This test can quickly and painlessly detect small changes in bone mass.

If your bones are losing density, you doctor may prescribe bone-strengthening medications known as bisphosphonates to help slow the rate of decline, or even restore bone density and quality, which can reduce the risk of future vertebral and other fragility fractures.