Compression Fractures

A compression fracture refers to the collapsing of a vertebra, which can occur either due to trauma or as a result of weakened vertebrae. Weakening of the vertebrae is often observed in individuals with conditions like osteoporosis or osteogenesis imperfecta, lytic lesions caused by primary or metastatic tumors, or infections. In healthy individuals, compression fractures are commonly associated with experiencing sudden and intense vertical shocks, such as those encountered when ejecting from an ejection seat.

Symptoms of Compression Fractures
The primary symptom of compression fractures is back pain. The pain may develop gradually and worsen over time or manifest suddenly with a sharp sensation. It is especially important for women aged 50 and above to inform their doctors about these symptoms.

Compression fractures of the spine can also lead to the following symptoms:

• Difficulty or inability to twist or bend the body
• Development of a curved spine
• Loss of height
• Increased pain while walking or standing, with mild relief when lying down

Pain commonly arises when performing regular daily activities that involve slight strain on the back, such as bending down to pick something up, lifting heavy bags, or engaging in household chores. Even tripping can trigger pain. After the fracture has healed, some individuals may continue to experience discomfort, while others may have mild pain due to the fractures occurring gradually and with minimal severity.

Symptoms of Multiple Spinal Compression Fractures
Multiple fractures result in more pronounced changes and noticeable symptoms. With multiple fractures, parts of the vertebrae may collapse due to inadequate spinal support. Symptoms of multiple fractures include:

• Breathing difficulties: Severe spinal compression can impede lung function, making breathing difficult.
• Loss of height: Each spinal bone fracture causes a slight reduction in spine length, resulting in a visibly shorter stature.
• Digestive issues: The compressed spine can also compress the stomach, leading to digestive problems such as weight loss, constipation, and decreased appetite.
• Kyphosis (curved back): Collapsed vertebrae can create a wedge shape, causing the spine to arch forward. This can lead to back and neck pain as the body tries to adapt.
• Hip pain: A shorter spine brings the hipbones and rib cage closer together, which can cause discomfort as the bones rub against each other.

Causes of Compression Fractures
While it is common to associate compression fractures with age-related back pain, there are underlying conditions that can contribute to these fractures:

• Osteoporosis: Osteoporosis is a common cause of fractures. It leads to thinning and weakening of the bones, particularly in women around the age of 60 who have undergone menopause. In severe cases of osteoporosis, even minor actions like sneezing or coughing can result in multiple fractures.
• Cancer: Compression fractures can be an initial indication of cancer or a consequence of cancer spreading to the bones. Lymphoma and myeloma are the most common cancers associated with compression fractures. If you have been diagnosed with either of these conditions, your doctor will monitor you for signs of compression fractures.

Individuals at higher risk of compression fractures include white and Asian women, women over the age of 50, thin women, smokers (who experience faster bone loss compared to nonsmokers), and women who experienced menopause before the age of 50.

Diagnosis and Treatment of Compression Fractures
If you suspect a compression fracture, your doctor will examine specific vertebrae along the spinal cord for tenderness and sensitivity. If a fracture is suspected, an X-ray will be ordered to confirm the diagnosis.

Treatment options for compression fractures include surgical and non-surgical approaches. Surgery is usually reserved for cases involving multiple severe fractures.

• Vertebroplasty: This minimally invasive treatment aims to reduce or eliminate pain caused by the fracture and stabilize the bone. Low-viscosity cement is injected into the collapsed vertebra to provide stability and alleviate pain.
• Fracture treatment: In most cases, surgery is not required, and instead, home care or physical therapy is recommended. Home care may involve pain medication, rest, application of ice or heat to affected areas, and gradually returning to mobility.
• Kyphoplasty: This is another minimally invasive procedure similar to vertebroplasty. It aims to reduce pain resulting from a fracture or osteoporosis by stabilizing the bones and restoring some of the lost height.