A vertebral compression fracture occurs when a vertebral body, or the primary bony component of the spine, collapses. The cause is often related to osteoporosis, a metabolic disease leading to loss of bone density that increases the risk of fracture.
The aging population has increased the number of severely osteoporotic subjects, mostly women. An estimated 10 million Americans have osteoporosis, and an additional 34 million are estimated to have osteopenia. Compression fractures and other spinal fractures can also be caused by certain types of cancer-related tumors or trauma.
An estimated 750,000 vertebral compression fractures occur every year in the US, which is becoming a public health problem of major proportions. The prevalence of those fractures is around 39% in subjects over age 65 years. Many people do not realize that sudden and intense back pain may be a sign of a spinal compression fracture. Sometimes people assume their back pain and other symptoms are just part of growing older.
Osteoporosis can cause a minor fall or simple bending and lifting movements to result in a major fracture. Whether painful or not, compression fractures can lead to additional fractures, spinal deformity, and loss of the ability to function. Recent studies have shown that osteoporotic vertebral compression fractures are associated with a significantly increased risk of mortality and decreased quality of life.
While vertebral compression fractures had previously been considered a burden to affected patients, there now are several minimally invasive treatment modalities that can be very effective. Vertebral augmentation techniques not only deal with the problem of pain, but also aim to restore the compressed vertebral body height and avoid possible kyphotic deformities.
A vertebral compression fracture should be suspected in any patient over 50 years of age with acute onset of lumbar or thoracic pain. In addition to pain, other signs and symptoms include:
- Loss of height (one of the reasons many older people seem to shrink as they age)
- Kyphosis (or humpback)
- Loss of balance (increases the risk of falling)
- Neurological symptoms such as numbness, tingling, or weakness (increases the risks of falling and breaking other bones)