X-Plain Vertebral Compression Fractures Reference Summary Introduction Back pain caused by a vertebral compression fracture, or VCF, is a common condition that affects thousands of people every year. A VCF is a fracture located in the vertebra. VCFs can be treated and even prevented in some cases. This reference summary will help you understand vertebral compression fractures. The tutorial discusses the causes and symptoms of vertebral compression factures, prevention methods and its treatment options. Causes The spine protects the spinal cord and nerves that go to different parts of the body. The spine is formed of solid vertebrae. The vertebrae are separated by softer disks. This is how a normal spine looks from the side. This is how a spine with VCF looks. The cracks in the vertebrae cause the spine to curve and weaken. Vertebrae Disks 1
Bone is a living tissue. It is mostly made of collagen, a protein that provides a soft framework and calcium phosphate, a mineral that hardens the framework. Our bones are continually replenished throughout life. The body deposits new bone and removes old bone. During childhood, more new bone is formed than old bone removed. The body s bone is the most dense and strongest around age 30. After age 30, the body starts removing more old bone than forming new bone! Osteoporosis, a disease that makes bones become weak and easier to break, is the leading cause of vertebral compression fractures or VCF. There are 2 main reasons why osteoporosis may occur: If a person does not have enough strong bone mass by age 30 before bone loss begins If bone loss after age 30 happens too fast. There are many other factors that may lead to osteoporosis and vertebral compression fractures. Menopause, Asthma, Diabetes, Rheumatoid arthritis and vitamin D deficiency, as well as use of some drugs can make a person more likely to get osteoporosis and VCF. Certain types of cancer and tumors can also cause vertebral compression fractures. Your risk of getting additional fractures increases a lot after your first fracture. This is because one fracture can cause the spine to become curved. When the spine is not aligned correctly, the stress of holding up the body incorrectly may lead to multiple fractures. As more and more vertebrae break the spine starts bending forward. This is known as kyphosis. Fractures involving more vertebrae are very common. Osteoporotic patients can break their vertebrae by simply sneezing or coughing! 2
Symptoms Symptoms of VCF can happen gradually, without any specific injury. Sometimes a person can have VCF and have no symptoms at all. Symptoms of VCF may include, long term and dull back pain, sudden and severe back pain, stooped posture or kyphosis, loss of height and decreased appetite. If you have any of these symptoms and also have osteoporosis, make sure to talk with your doctor. Doctors diagnose a VCF with radiographic images such as X-Rays, MRIs, CT scans, and nuclear scans. Treatment After diagnosing VCF, the doctor may prescribe bed rest and medication for controlling the pain. This will not treat the shape of the spine, which may cause future VCFs from stress. The use of a brace may help with the symptoms. Doctors may recommend a procedure known as vertebroplasty. In vertebroplasty the doctor injects medical cement into the vertebral fracture. This may treat the fracture but does not treat the spinal deformity. Doctors may recommend Balloon Kyphoplasty. The word kyphoplasty Back Brace means correction of the kyphosis. In Balloon Kyphoplasty, the doctor lifts the fracture and injects medical cement into it. This treats the fracture and the spine deformity. If the reason that lead to your fracture is not treated, new fractures could happen. If you have osteoporosis, you should eat food that includes calcium and vitamin D including dairy products, such as milk and cheese, and oranges. 3
Calcium supplements are as effective as calcium from food. They are inexpensive and well tolerated by the body. Some prescription medications help calcium get into new bone. Some are prescribed in the form of a nasal spray. Other medications are available to help slow down bone loss. Some have been shown to increase bone density and decrease the chances of future fractures. There are medications that have an estrogen like effect on bone metabolism. These medications may have some unwanted and serious side effects such as blood clots in the legs. Injectable medications that contain normally occurring hormones may help build more bone. If your VCF was caused by a tumor, your doctor may want to take a sample to find out more about it. A tumor may be removed surgically or treated with radiation therapy. Depending on the nature of the tumor, you may need other treatments as well. Prevention You can help prevent VCFs by treating the underlying cause and making some lifestyle changes. People who develop osteoporosis should not lift, push, or pull heavy objects. They must be careful not to trip on thick carpet or throw rugs, or fall on slippery surfaces. People with osteoporosis should keep their homes well lit and take their time getting from place to place, especially at night. Using a walker or cane in unfamiliar surroundings can be helpful. It is very important to have the osteoporosis treated. It is also important to realize that NO osteoporosis treatment makes the bone immediately as solid as it used to be. It takes a very long time to strengthen the bones. This again is why patients have to be VERY careful not to stress their spines with heavy lifting, bending or twisting. 4
Summary Back pain caused by a vertebral compression fracture, or VCF, is a common condition that affects thousands of people every year. Several treatment options are available. Some aim at fixing an existing VCF and others at treating the underlying cause. In combination, these treatments can help heal and prevent future VCFs. Osteoporosis is the leading cause of VCF. Treatment of osteoporosis is important and can help prevent future VCFs from happening. People with osteoporosis should keep their homes well lit and take their time going from place to place, especially at night. Using a walker or a cane in unfamiliar surroundings can be helpful. 5