Spine Fractures: Everything You Need To Know

It is the first warm day of spring and you decide that a little spring cleaning is in order. You bend over and open a window to let in some fresh air, when you feel a sharp pain in your lower back. At first you attribute it to a pulled muscle, but the pain soon becomes severe. This seemingly trivial trauma led to a compression fracture in your lower back! Let’s take a closer look at spine fractures and why we want to prevent them!

A spine fracture refers to a break in any of the bones which make up the spinal column in your back. Compression fractures of the spine are particularly common in those suffering from osteoporosis. With this type of fracture, weakened spine bones can suddenly collapse from forces such as coughing, sneezing, bending forward, lifting an object, or falling. In other instances, the spine bones may slowly collapse over time due to an accumulation of minor trauma throughout everyday life.

Just how common are these fractures?
Compression fractures of the spine are the MOST COMMON type of fracture caused by osteoporosis. The exact number is unknown, since many of these fractures go undetected, but it is estimated that there are over 1.5 million compression fractures in the United States each year! This amounts to a hefty $750 million annual price tag for office visits and treatments!

What are symptoms of compression fractures?
The most unsettling part of compression fractures is that only one-third of people will experience significant symptoms that will make them seek medical treatment. Nearly two-thirds of people with compression fractures don’t even know they have one! By no means would anyone ever wish the pain of a fracture on somebody, but knowing that you have a compression fracture is valuable information. The spine is a window into the overall health of the skeleton. Compression fractures tend to occur before more serious fractures, including hip fractures. If we are able to catch osteoporosis early, then we can start appropriate treatment to reduce the risk of other fractures. If someone experiences a compression fracture and it goes undetected, studies indicate that nearly 20% of these people will go on to break another bone within 1 year!

So what symptoms should you look out for? Compression fractures can cause a sudden onset of pain in the middle of the back. This is often associated with painful muscle spasms. The pain is worse with changes in position, and may lessen as you settle into a sitting or lying position. Occasionally, severe compression fractures can cause bone fragments to pinch a nerve in your back, leading to radiating pain and weakness into one or both legs. Subtle signs of compression fractures include a loss of height over time and a “hunched over” posture known as kyphosis.

How are compression fractures treated?
Treatment of compression fractures depends on the severity of the fracture. The majority of compression fractures can be managed without any surgical procedures. Standard treatment includes pain management, avoidance of certain activities including lifting and forward bending, and occasionally back bracing and physical therapy. For most, pain will subside over a period of 3-4 months. However, some may experience lingering symptoms.

Compression fractures which cause debilitating pain and loss of function are often best managed by surgical procedures known as vertebroplasty and kyphoplasty. During these procedures, cement is injected into the site of the fracture which dramatically decreases pain and allows for a more rapid recovery. Rarely, severe compression fractures with displaced bone fragments may cause injury to the nerves in the spine. This condition is treated by surgery to remove pressure on your nerves and to stabilize the fracture.

What are complications of compression fractures?
As I previously mentioned, nearly two-thirds of compression fractures are associated with minimal symptoms. This may give you a false sense of security, but don’t be fooled! Compression fractures are associated with possible side effects and long term consequences. If multiple compression fractures occur over time, you may find yourself becoming shorter and taking on a hunched over posture. Severe kyphosis can lead to crowding of internal organs as your ribcage presses down on your pelvis. This has also been linked to breathing problems. Painful compression fractures can cause prolonged inactivity, blood clots, and muscle weakness. Those with prior compression fractures are more likely to require long term nursing home care.

The bottom line on compression fractures…
Spine compression fractures are the most common type of osteoporosis-related fracture, numbering more than 1.5 million in the United States each year! The majority of compression fractures can be managed without surgery, however, severely painful and debilitating injuries may require surgical treatment (vertebroplasty or kyphoplasty) to stabilize the fracture and lessen pain. Compression fractures help us predict future osteoporosis-related fractures, and studies indicate that nearly 20% of people will break another bone in the year following their injury. The most common long term consequences of compression fractures include height loss and a hunched over posture, but you are also at risk for nerve injury, muscle weakness, and loss of independence.