Spinal Fracture

Vertebral Compression Fracture

A vertebral compression fracture (VCF) occurs when a vertebral body in the spine is compressed and the bone collapses. A VCF happens when force exceeds the bone’s strength, such as during a traumatic fall or car accident. VCFs can be extremely painful and can lead to limited mobility, loss of height (stature), and spinal deformity. Osteoporosis increases the risk for vertebral compression fractures.

1-313Compressive forces cause a VCF

Symptoms of a Vertebral Compression Fracture

The foremost symptom of a VCF is the sudden onset of back pain. Often, pain is severe and disabling. Pain can be accompanied by numbness, weakness, and shortness of breath. Furthermore, pain usually increases when sitting, standing, or walking.

Some patients may suffer multiple vertebral fractures either all at once or over time. Osteoporosis is often a cause. Not only does osteoporosis increase the risk for a single vertebral fracture, but for adjacent VCFs too; similar to a “domino” effect.

Multiple VCFs may cause:

  • Hunched back (“dowager’s hump”)
  • Bulging abdomen
  • Internal organs may become “crowded”
  • Gastrointestinal problems
  • Shortness of breath. In the thoracic spine, multiple VCFs may shorten the torso affecting lung capacity making it difficult to breathe.
  • Hip pain (hip fracture)

In severe cases, a part of the vertebral body may protrude into the spinal canal and compress the spinal cord and/or nerves. Depending on where the fracture occurs (eg, neck, mid-back, low back), symptoms may include bowel, bladder, or other organ dysfunction.

Vertebral Compression Fracture Requires Immediate Medical Care

Whether the VCF occurs in the cervical (neck), thoracic (mid-back), or lumbar (low back) region, urgent care is required. The neurosurgeon will most likely order one or more imaging tests to confirm the type of spinal fracture, its location, and see if bone has broken away and/or is compressing a nerve structure.

  • X-ray
  • MRI evaluates the fracture and surrounding soft tissues (eg, nerves)
  • Nuclear bone scan may determine the presence of a previous fracture
  • DEXA scan evaluates bone density

VCF Treatment

The order of treatment is (1) reduce pain, (2) stabilize and repair the fracture, and (3) diagnose the cause of the vertebral compression fracture. Treatment may include pain medication, activity modification, an epidural steroid injection to reduce nerve inflammation, drugs to improve bone density, and physical therapy. If appropriate, a spinal brace may temporarily stabilize the fracture and reduce pain.

Vertebroplasty and kyphoplasty are minimally invasive spine procedures performed to stabilize and repair a vertebral compression fracture(s). The neurosurgeons at Charleston Brain and Spine routinely perform these procedures and have had excellent patient outcomes.