Compression fractures are fractures in the bones of the spine (the vertebrae) that typically occur as a result of osteoporosis, a progressive condition that causes loss of bone mass and bone weakening. Compression fractures usually begin as a series of small fissures or tiny cracks in the vertebrae that, over time, cause the vertebrae to weak. Eventually, the bone can collapse or become compressed, resulting in chronic and sometimes severe back pain. Spinal compression fractures become much more common with age and they’re more common among menopausal women and among smokers, groups that also tend to have a higher risk of developing osteoporosis.
Spinal compression fractures are diagnosed with a physical exam, a patient history, and x-rays to confirm the diagnosis. Many patients with spinal compression fractures have a characteristic “stoop” when they stand, a condition called kyphosis that develops because the weaker front portion of the vertebrae tend to compress more rapidly than the harder back portion of the bone, resulting in a wedge-shaped bone that causes the back to curve.
Treatment for compression fractures depends on the severity of the condition as well as other factors. Some patients may benefit from nonsurgical interventions like pain medications and rest combined with the use of a back brace during healing. Taking bone-strengthening drugs may also help to stabilize the spine bones and prevent or minimize additional bone loss. Patients with more severe fractures may require back surgery. Today, minimally-invasive techniques like kyphoplasty and vertebroplasty use small incisions for fewer risks, less discomfort, and much faster healing. These techniques use a special acrylic cement to stabilize the spine and prevent further damage and discomfort. The cement is administered through a long tube called a catheter. In kyphoplasty, a tiny balloon is inserted first to help reshape the bone before the cement is injected into the space. For very severe fractures, spinal fusion surgery may be needed to fuse together two vertebrae, preventing movement in that area of the back.