What is a Vertebral Compression Fracture?

Overview

Vertebral compression fractures, or spine fractures, are a broken bone, or cracked vertebrae, in your spine. Vertebral compression fractures range from a painful compression fracture to more severe injuries such as a burst fracture and fracture-dislocations, often the result of traffic accidents or falls from height. In the case of vertebral compression fractures, osteoporosis or cancer is likely to have compromised the vertebra’s ability to withstand even limited pressure. When the limit is exceeded, and the vertebra is unable to handle the stress, it collapses and becomes wedge shaped.

How common are vertebral compression fractures?

The prevalence of cracked vertebrae and vertebral compression fractures is increasing steadily as the U.S. population ages. Presently, vertebral compression fractures affect an estimated 25% of all postmenopausal women1 and 40% of women age 80 and older.1
Anyone with significant back pain – especially women age 50 and older – should see a physician.

What are the symptoms of a vertebral compression fracture?

One or more symptoms can indicate that you may be suffering from a vertebral compression fracture, burst fracture, or cracked vertebrae:

  • Sudden, severe back pain
  • Standing or walking worsens your back pain
  • Lying down provides you only minor back pain relief
  • Bending and twisting are difficult and painful for you to perform
  • You experience a loss of height
  • Your spine becomes deformed or curved, taking on a ‘hunchback’ shape

What are the causes of vertebral compression fractures?

The main causes of vertebral compression fractures are osteoporosis and cancer.

Osteoporosis
Osteoporosis affects more than 10 million Americans.2 Of those affected, 80% are female. It is estimated that as many as 14 million Americans will have osteoporosis by 2020 if efforts are not made to stem the disease.2 The disease, which weakens bone over time, results in more than 1.5 million fragility fractures annually in the U.S., of which 900,000 are spine fractures.3

Trauma
Spine trauma can occur when your are involved in a sudden and/or severe accident in which the pressure on your vertebrae exceeds your spine’s ability to remain stable, thereby causing the one or more vertebra to collapse.

Pathologic Fracture
Pathological fractures occur when a vertebra is weakened by an underlying or preexisting disease or condition, for example, cancer. When the primary disease alters the structure of the vertebra, the vertebra can fracture spontaneously or with only minimal trauma, causing it to collapse. Treating a pathologic fracture includes treating the underlying disease.

Spine Tumors
Spine tumors can be benign (non-cancerous) or malignant (cancerous). Some malignant tumors are known to metastasize, or spread, via arteries, veins, the lymphatic system, and directly. Spine tumors located in the vertebra are most commonly associated with multiple myeloma, a malignant tumor of the bone marrow, and primary cancers of the breast, lung, kidney, and prostate which metastasize (spread) to the spine.

What happens if vertebral compression fractures are left untreated?

Until the early 1990s, vertebral compression fractures were managed through the use of pain medication, bed rest, and bracing. Some patients improved over time while others did not. In some cases this led to chronic pain long after the fracture had healed.

A recent study of Medicare patients suffering vertebral compression fractures showed that those who underwent minimally invasive procedures to treat the fracture were 18% more likely to survive after four years than patients who did not undergo the procedure.4

References

  1. Old JL, Calvert M. Vertebral Compression Fractures in the Elderly. Am Fam Physician. 2004 Jan 1;69(1):111-116
  2. National Osteoporosis Foundation. Clinician’s Guide to Prevention and Treatment of Osteoporosis. 2008.
  3. Medtronic, Inc. updated estimate from 700,000 spinal fractures estimated in 1985-89 study: Riggs BL, Melton LJ 3rd. The worldwide problem of osteoporosis: insights afforded by epidemiology. Bone. 1995;17 Suppl 5:S505-511 for demographics and incidence rate per Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A. Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025. J Bone Miner Res. 2007; 22:465-475.
  4. Edidin AA, Ong KL, Lau E, and Kurtz SM. Mortality risk for operated and non-operated vertebral fracture patients in the Medicare population. J Bone Miner Res. 2011 Jul;26(7):1617-1626.