A spinal compression fracture occurs when a vertebra, one of the bony blocks in your spine, collapses and becomes shorter in height.
What is a Spinal Compression Fracture?
A spinal compression fracture involves the collapse or wedging of a vertebral body. These fractures commonly occur in the thoracic (middle back) and lumbar (lower back) regions of the spine. The most frequent cause, especially in older adults, is osteoporosis, a condition where bones lose density and become fragile. Even minor activities like bending or coughing can cause a fracture in someone with severe osteoporosis.
Trauma, such as falls or car accidents, can also lead to compression fractures by exerting excessive pressure on the spine. Less commonly, underlying conditions like tumors or infections can weaken the vertebrae, making them susceptible to collapse. Symptoms often include sudden, severe back pain that may worsen with standing or walking. Over time, these fractures can result in a loss of height or a stooped posture, known as kyphosis.
Factors Influencing Severity
The severity of a spinal compression fracture depends on several factors, including the extent of vertebral collapse. A fracture with significant bone compression indicates a more severe injury. Imaging studies determine the degree of height loss in the affected vertebra.
The fracture’s impact on the spinal cord or nerves is another factor. If bone fragments press on these structures, it can lead to neurological symptoms like numbness, tingling, weakness, or problems with bladder or bowel control. The number and location of fractures also play a role, as multiple fractures or those in critical areas can increase overall severity.
The underlying cause also influences severity. Fractures from high-impact trauma, tumors, or infections may be more complicated than those caused by osteoporosis. A medical professional assesses these elements to determine severity and appropriate action.
Diagnosis and Treatment Options
Diagnosis begins with a physical examination, where a doctor assesses for tenderness and evaluates posture. Imaging techniques confirm the diagnosis and provide detailed views. X-rays are often the initial test, showing fractures. CT scans offer detailed cross-sectional images, revealing bone damage and fragments. MRI scans are useful for visualizing soft tissues like the spinal cord and nerves, detecting compression, or identifying underlying conditions.
Treatment options vary based on the fracture’s severity and cause. Conservative management is the first approach, focusing on pain relief. This may involve pain medications, temporary rest, and back braces to stabilize the spine. Physical therapy is also part of conservative care, helping to strengthen supporting muscles and improve flexibility once pain subsides.
If conservative treatments are not effective, or for more severe fractures, surgical interventions are considered. Vertebroplasty involves injecting bone cement into the fractured vertebra to stabilize it and reduce pain. Kyphoplasty is a similar procedure where a balloon inflates within the vertebra to restore height before cement injection. Both procedures stabilize the fracture and alleviate pain; kyphoplasty also corrects some spinal deformity.
Recovery and Prognosis
Recovery varies depending on fracture severity, treatment, and overall health. Many stable fractures heal within two to three months with conservative management, though full recovery might take up to a year. Patients undergoing surgical procedures like vertebroplasty or kyphoplasty often experience pain relief within 24 to 48 hours and can resume light activities quickly.
Despite healing, some individuals may experience long-term complications. These can include chronic pain, continued height loss, or increased kyphosis. In rare, severe cases, if neurological involvement was significant or fragments press on the spinal cord, long-term neurological deficits may persist. Rehabilitation, including physical therapy, is important for regaining strength and function. It helps improve posture, strengthen back muscles, and enhance balance, important for preventing falls.
For those whose fractures are linked to osteoporosis, proactive management reduces the risk of future fractures. This includes maintaining adequate bone density through diet, exercise, and medication. Avoiding high-impact activities and practicing safe body mechanics helps protect the spine. Regular follow-up with healthcare providers monitors bone health and adjusts prevention strategies.