Vertebral Compression Fractures
A vertebral compression fracture is a collapse of the front part of a vertebra, most often in the mid or low back. In older adults the usual cause is osteoporosis, and the injury may be as minor as lifting a bag or a hard sit. Most heal with time and support. The fracture is also a warning about bone health that should not be ignored.
Diagnosis
X-rays show the collapsed vertebra. An MRI is often used to confirm the fracture is recent, to check for involvement of the spinal canal, and to look for causes other than osteoporosis. Because a compression fracture in an older adult usually means the bone is weak, a bone density test (DEXA) and basic laboratory studies are part of the evaluation.
Healing without a procedure
Most compression fractures become significantly less painful over four to eight weeks. Treatment during that time consists of pain medication, a brace for comfort when upright, and gradual return to walking and daily activities. Prolonged bed rest weakens bone and muscle and is avoided. Physical therapy helps with posture and safe movement once pain allows.
Kyphoplasty
When pain remains severe after several weeks despite care, or when the vertebra continues to collapse, kyphoplasty is an option. Through a small incision, a balloon is inflated inside the fractured vertebra to restore some height, and the cavity is filled with bone cement to stabilize the fracture. It is typically an outpatient procedure under sedation or general anesthesia, and pain relief is often rapid. Fractures that are unstable or pressing on the spinal cord or nerves are treated with surgical stabilization instead.
Protecting the rest of the spine
One osteoporotic fracture substantially raises the risk of another. Treating the underlying bone loss with medication, calcium and vitamin D, weight-bearing exercise, and fall prevention is as important as treating the fracture. Dr. Michael coordinates bone health evaluation with your primary care physician or an endocrinologist.
Common questions
Do compression fractures heal on their own?
Most do, over roughly four to eight weeks, with pain control and bracing. Kyphoplasty is reserved for fractures that remain painful or continue to collapse.
Is kyphoplasty a major surgery?
No. It is a minimally invasive outpatient procedure done through a small incision, and most patients notice improvement within a day or two.
Why do I need a bone density test?
A compression fracture from minor trauma is itself a sign of weak bone. Measuring and treating bone density lowers the chance of the next fracture.