Compression Fracture

What is a compression fracture?

A compression fracture is a type of fracture, or break, that occurs in the vertebrae of your spine. The vertebrae are the bones in your back that are stacked on top of each other to make your spine. Your spine supports your weight, allows you to move, and protects your spinal cord and the nerves.

Compression fractures can cause the vertebrae to collapse, which can make them shorter in height. This collapse may even cause pieces of bone to press on the spinal cord and nerves, causing pain and possible nerve damage to the spinal cord. 

What causes a compression fracture?

Osteoporosis is the most common cause of compression fractures. It is a type of bone loss associated with aging that causes bones to break easily.

Other causes include injuries to the spine (such as from car accidents and sports injuries) and tumors in the spine. The tumor may start in the vertebrae, but more commonly it spreads there from another part of the body to the bone. 

What are the symptoms of a compression fracture?

When compression fracture first occurs, it may not cause any symptoms at all. Your doctor may discover it on an X-ray that you had done for other reasons. Other symptoms may include:

• Slowly worsening back pain — lying on your back may relieve the pain and standing may make it worse
• If the fracture happens rapidly, you may experience sudden, severe back pain.
• A decrease in your height may occur
• Stooped over posture
• Decreased ability to move your spine (difficulty bending or twisting)
• Numbness or tingling, muscle weakness, problems walking
• Possible difficulty controlling your bowels or bladder due to nerve damage 

How is a compression fracture diagnosed?

The process starts with talking with you about your medical history and recent injuries and a physical exam. Imaging studies, such as X-rays, computed tomography (CT), or magnetic resonance imaging (MRI) scans, may be required to further investigate the cause. 

What are possible complications of a compression fracture?

Complications of compression fractures include:

• Fractured bones that do not heal after treatment, which can lead to chronic pain and damage of the nearby vertebrae
• Blood clots in the legs due to decreased mobility
• Kyphosis (a deformity also called dowager’s hump or humpback) that can lead to severe pain and problems with organs in the chest (such as the heart, lungs, and digestive organs)
• Spinal cord or nerve problems 

How is a compression fracture treated?

If your compression fracture is related to osteoporosis, your healthcare provider will want to treat the osteoporosis. You may need to take bone-strengthening medicine and calcium and vitamin D supplements. Physical therapy and exercises may be recommended, to help strengthen your bones and in the hope of preventing future fractures.

Advanced interventional procedures are also available and may be indicated if other treatments aren't helping:

• Kyphoplasty. attempts to restore the height a fractured vertebrae, followed by its stabilization by injecting a type of bone cement. The procedure uses a small needle to gain access into the injured vertebrae, then a small balloon or canula is used to create a void within the bone. Once the void is created, bone cement is delivered directly into the newly created void.
• Spine Tumor Ablation with Radiofrequency (STAR). if a tumor is causing your symptoms, this procedure may be indicated. It is similar to kyphoplasty, except before injecting cement, radiofrequency energy is applied to heat up and destroy the tumor cells.

If an injury has caused the fracture, you may need surgery, called a fusion, to repair the bone and join vertebrae together. If a tumor is causing your symptoms, you may need radiation therapy as well as surgery to remove some of the bone and treat the tumor.