Understanding Vertebral Compression Fractures

Vertebral compression fractures can range from a compression fracture of thoracic spine to more severe injuries such as vertebral burst fractures and fracture-dislocations, generally the result of traffic accidents or falls from height. Most common, however, are compression fractures caused by osteoporosis or cancer, which compromise the vertebra’s structural integrity and can lead to vertebral collapse and compression fractures of the spine.

Vertebral compression fractures can have debilitating effects on a patient's quality of life. Encourage your patients who report having significant back pain – especially women age 50 and older – to schedule an appointment to discuss their back pain.

Prevalence
The prevalence of 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

Causes
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 fractures3 annually in the U.S., of which 900,000 are spine fractures.4 Risk factors for osteoporosis include:

  • Age: 50+
  • Family history of osteoporosis or broken bones
  • Personal history of broken bones
  • Physical build: small, thin
  • Race/ethnicity: Caucasian, Asian, Hispanic/Latino, and less so, African American
  • Diet: Low calcium, vitamin D intake; excessive protein, sodium, caffeine intake
  • Low hormone levels
  • Inactive lifestyle
  • Smoking

Direct medical costs attributed to osteoporotic vertebral compression fractures are estimated to be about $1.1 billion.5 By 2025, analysts project the number of annual fractures and costs to rise nearly 50%.5 The real costs are actually much higher when indirect costs such as time off work, pain, diminished mobility, insomnia, and depression are taken into consideration.

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

References

  1. Old JL, Calvert M. Vertebral Compression Fractures in the Elderly. Am Fam Physician. 2004;69(1):111-116.
  2. National Osteoporosis Foundation. Clinician’s Guide to Prevention and Treatment of Osteoporosis. 2008.
  3. 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. 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.
  5. Kondo ML. Osteoporotic Vertebral Compression Fractures and Vertebral Augmentation. Semin Intervent Radiol. 2008;25(4):413-424.