Compression fractures of the spine are when the vertebrae (bones of the spine) themselves collapse, often more than one. Compression is most commonly caused by osteoporosis, back trauma and tumors in the bone. Multiple spinal fractures may lead to kyphosis, a humped curvature of the spine.
Causes of Spine Compression
Compression fractures of the spine are most commonly caused by osteoporosis, or bone loss, which thins and weakens the bones and makes them more vulnerable to fracture. Other causes of compression fractures include:
- Trauma to the back
- Tumors in the bone
If you have multiple fractures in your spine, you may get kyphosis, which is a hump-like curvature in your spine.
Diagnosis & Testing
Your doctor will conduct a physical examination of your spine, and will determine whether you have kyphosis or any tenderness in regions along the affected bones of your spine.
Other tests may include:
- Bone density test to determine if you have osteoporosis
- A computed tomography (CT) or magnetic resonance imaging (MRI) scan in instances of trauma or if a tumor is suspected to be causing the fracture
- Spine X-ray to evaluate the condition of the compressed vertebra
Signs & Symptoms
Compression fractures cause severe, usually disabling back pain most often felt in the mid-to-lower part of the spine. This pain may take weeks or even months to go away.
Spine compression caused by osteoporosis may be asymptomatic at first, and only be discovered upon X-ray of the spine. If untreated, symptoms may occur, including:
- Progressive back pain, worsening especially when walking, although not felt when at rest
- Loss of height (as much as six inches)
- Kyphosis, or “dowager’s hump”
Compression fractures are most commonly found in elderly patients with osteoporosis, and since these fractures typically do not injure the spinal cord, are often treated with prescription medications and calcium supplements.
Pain from these fractures is usually treated with bed rest and pain medications. Back braces are discouraged, as they may further weaken the bones and increase the risk of development of more fractures in the future.
Physical therapy is often used to help build up muscle strength and flexibility around the spine.
Surgery can be an option if disabling pain is there after two months or more of bed rest, physical therapy, and medications. There are some minimally-invasive surgical options available to patients.
Balloon kyphoplasty: Typically done under general anesthesia, this surgery describes a large needle inserted into a compressed vertebra. A balloon is then inserted into the bone and is inflated, which returns the vertebra to its original height. Cement is then injected to make sure the bone does not collapse again.
Vertebroplasty: Similar to the balloon kyphoplasty, this surgery requires only local anesthesia and sedation.
If a tumor has caused the fracture, a biopsy will be obtained and examined, and treatment of the tumor will commence. The following cancers commonly involve the spine:
- Breast Cancer
- Lung Cancer
- Prostate Cancer
A back brace may be necessary in the event of a trauma fracture, worn anywhere from six to 10 weeks, in order to protect the bone as it heals. If adequate rest and bracing has occurred, most compression fractures from trauma will heal in eight to 10 weeks, although recovery times may take far longer.
Compression fractures caused by osteoporosis usually become less painful with time, rest and pain medications, although sometimes they can lead to chronic pain and disability.