Vertebral fractures generally occur as a result of trauma and weakened bones due to underlying conditions such as osteoporosis. Bony fragments in vertebral fractures can cause damage to the spinal nerves and the spinal cord. Vertebral fractures may lead to mild effects on the ligaments/muscles or can lead to severe debilitating effects on the spinal cord, depending on the causative factors and the impact of the injury. Treatment of vertebral fractures depends on the type and severity of the injury/fracture.
What are Vertebral Compression Fractures?
Vertebral Compression Fractures (VCFs) occur due to collapse of the vertebral body of the spine. The most common areas of VCFs are the mid and lower spinal regions (thoracic and lumbar spine).
Causes and risk factors of Vertebral Compression Fractures (VCFs)
The following are some of the causes of vertebral compression fractures:
- Osteoporosis: It is one of the most common causes of VCFs. Osteoporosis is a condition which is associated with weakened and brittle bones, that are more susceptible to fractures.
- Trauma from falling down, lifting heavy objects, car accidents etc.
- Spinal infections may weaken vertebral bones, resulting in their collapse.
- Spinal tumours
Other risk factors:
- Age
- Bone changes in post-menopausal women
- Vitamin D deficiency
Signs and symptoms of Vertebral Compression Fractures (VCFs)
Some major signs and symptoms of VCFs include:
- Back pain
- Numbness and weakness of arms and legs (fractures with nerve impingement)
- Increasing pain while walking, standing
- Limited range of motion in the spine
- Decreased pain intensity while lying on the back
- Progressive loss of height
- Progressive disability, deformity.
Diagnosis of Vertebral Compression Fractures (VCFs)
Diagnosis of VCFs is based on thorough medical history, physical examination and diagnostic imaging scans.
Physical examination involves evaluation of height, range of motion, reflexes, location of pain and factors responsible for high intensity pain.
Diagnostic imaging: X-rays with lateral views of the vertebral column are taken to assess the decreased height of the vertebral body and to identify an anterior wedge fracture, which is a characteristic feature of VCFs. MRI and CT scan are recommended in patients with poor response to conservative treatment and worsening symptoms of the fracture.
Treatment of Vertebral Compression Fractures (VCFs)
Conservative management methods for VCFs include:
Physical therapy: Initially, bed rest may be recommended in cases of unbearable pain followed by back strengthening exercises. Bracing may be helpful in improving spine posture.
Medications: Non-steroid Anti-Inflammatory Drugs (NSAIDs) and muscle relaxants are recommended for pain relief and increased ability to take part in physical therapy.
Surgical Management of VCFs includes:
Patients with poor response to conservative methods are considered for surgical management.
Vertebroplasty is a procedure in which acrylic bone cement is injected in the area of collapsed vertebra using a small needle. This helps to strengthen and stabilize the vertebrae that are fractured.
Kyphoplasty is a modified form of vertebroplasty which uses a balloon to inject cement, reduce pain and maintain vertebral height in the area of collapsed vertebrae.
