Compression fractures of the back
Compression fractures of the back are broken vertebrae. Vertebrae are the bones of the spine.
Vertebral compression fractures; Osteoporosis - compression fracture
Osteoporosis is the most common cause of this type of fracture. Osteoporosis is a disease in which bones become fragile. In most cases, bone loses calcium and other minerals with age. Other causes may include:
Having many fractures of the vertebrae can lead to kyphosis. This is a hump-like curvature of the spine.
Compression fractures can occur suddenly. This can cause severe back pain.
Compression fractures due to osteoporosis may cause no symptoms at first. Often, they are discovered when x-rays of the spine are done for other reasons. Over time, the following symptoms may occur:
Pressure on the spinal cord from hunched over posture can, in rare cases, cause:
Exams and Tests
Your health care provider will perform a physical exam. This may show:
A spine x-ray may show at least 1 compressed vertebra that is shorter than the other vertebrae.
Other tests that may be done:
Most compression fractures are seen in older people with osteoporosis. These fractures often do not cause injury to the spinal cord. The condition is usually treated with medicines and calcium supplements to prevent further fractures.
Pain may be treated with:
Other treatments may include:
Surgery may be done if you have severe and disabling pain for more than 2 months that does not get better with other treatments. Surgery can include:
Other surgery may be done to remove bone if the fracture is due to a tumor.
After surgery you may need:
Most compression fractures due to injury heal in 8 to 10 weeks with rest, wearing of a brace, and pain medicines. However, recovery can take much longer if surgery was done.
Fractures due to osteoporosis often become less painful with rest and pain medicines. Some fractures, though, can lead to long-term (chronic) pain and disability.
Medicines to treat osteoporosis can help prevent future fractures. However, medicines cannot reverse damage that has already occurred.
For compression fractures caused by tumors, the outcome depends on the type of tumor involved. Tumors that involve the spine include:
Complications may include:
When to Contact a Medical Professional
Call your provider if:
Taking steps to prevent and treat osteoporosis is the most effective way to prevent compression or insufficiency fractures. Getting regular load-bearing exercise (such as walking) can help you avoid bone loss.
Cosman F, de Beur SJ, LeBoff MS, et al. Clinician's guide to prevention and treatment of osteoporosis. Osteoporos Int. 2014;25(10):2359-2381. PMID: 25182228 www.ncbi.nlm.nih.gov/pubmed/25182228.
Klazen CA, Lohle PN, de Vries J, et al. Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open-label randomised trial. Lancet. 2010;376(9746):1085-1092. PMID: 20701962 www.ncbi.nlm.nih.gov/pubmed/20701962.
Savage JW, Anderson PA. Osteoporotic spinal fractures. In: Browner BD, Jupiter JB, Krettek C, Anderson PA, eds. Skeletal Trauma: Basic Science, Management, and Reconstruction. 5th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 37.
Wardlaw D, Cummings SR, Van Meirhaeghe J, et al. Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial. Lancet. 2009;373(9668):1016-1024. PMID: 19246088 www.ncbi.nlm.nih.gov/pubmed/19246088.
Williams KD. Fractures, dislocations, and fracture-dislocations of the spine. In: Azar FM, Beaty JH, Canale ST, eds. Campbell's Operative Orthopaedics. 13th ed. Philadelphia, PA: Elsevier; 2017:chap 41.
Review Date: 9/7/2017
Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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