compression fractures of the back Alternative Names
vertebral compression fracture
Brought on by force, a compression fracture is a break in the vertebra that causes it to collapse. The vertebra are the box-shaped bones that make up the spine. Typically, a compression fracture is wedge-shaped, with more collapse in the front, due to force on the spine from forward bending.
What is going on in the body?
The spinal column of vertebrae, stacked one on top of another, supports the body in an upright position. When the force on the bone is greater than the strength of the bone, a compression fracture occurs. Fractures can also occur when the bones have been weakened. For example, in osteoporosis, fractures can occur spontaneously with no known injury. Compression fractures occur most frequently in the lower back or lumbar area. They also occur in the chest or thoracic area of the spine.
What are the signs and symptoms of the condition?
Mild, moderate, or severe back pain, particularly in the upright position, is the main complaint. Lying down may relieve some of the discomfort. In most cases, the discomfort lessens significantly within 6 to 8 weeks.
If several vertebrae are compressed, a rounded or hunched back may be noticed. Rarely, the compression fracture may be severe enough to cause pressure on the spinal cord or nerves. If this occurs, it could result in numbness, weakness, or paralysis of the legs, bladder, or bowels.
Other signs include tenderness over the compressed vertebra and spasm of the surrounding muscles. Standing with an erect posture may be difficult.
What are the causes and risks of the condition?
Most people remember a specific injury as the cause. In young, healthy bone, a violent force such as a car accident or fall from a height is necessary to break the bone. In weak, thin bone, minor force such as sitting down hard or vigorous sneezing can cause the compression. Bone can be weak for various reasons, the most common being osteoporosis. Cancer can also weaken a vertebra.
What can be done to prevent the condition?
This condition can be avoided by maintaining healthy bones through proper diet, including calcium and vitamin D intake, and weight-bearing exercise.
How is the condition diagnosed?
Compression fractures of the back are suspected based on history, symptoms, and signs. The diagnosis is confirmed by spine x-rays, particularly from the side view. Rarely, special x-ray tests such as a bone scan, MRI, or CT scan, are used to make the diagnosis. The MRI and CT scan can give greater detail in more severe injuries that press on the spinal cord.
What are the long-term effects of the condition?
The majority of compression fractures will heal without long-term problems. The greater the collapse, however, the greater the chance of future back pain. There is possible worsening of the collapse that may cause nerve problems or require an operation.
What are the risks to others?
There are no risks to others.
What are the treatments for the condition?
Often rest, reduced activity, and analgesia are sufficient to relieve the discomfort. Temporary use of a back support, such as a brace, corset, or girdle, may ease the discomfort. For more serious compression fractures, a substantial brace or body cast may be necessary. This will help protect the spine during the healing phase and prevent future collapse. For the most severe injuries, particularly those with neurological problems, an operation to correct the collapse and fuse the spine may be considered. As the fracture heals, it is important to perform muscle-strengthening exercises to straighten the back. Physiotherapy may be used to teach the individual proper use of the body for lifting and other physical activities.
What are the side effects of the treatments?
An operation might result in nerve injury, failure to correct the deformity, failure of the bone fusion to heal, or infection.
What happens after treatment for the condition?
Pain is often relieved following rest, reduced activity, analgesia, and physiotherapy.
How is the condition monitored?
Comfort level and posture should be monitored by the doctor.
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Potential conflict of interest information for reviewers available on request