A compression fracture occurs when part of a vertebra collapses. A compression fracture is usually defined as a vertebral bone in the spine that has decreased at least 15% to 20% in height due to fracture. These can occur in vertebrae anywhere in the spine, but most often occur in the middle and lower back. In many cases, the vertebra with a compression fracture is already weakened. The most common cause of this weakening is osteoporosis, a condition that causes brittle bones. Because the majority of damage is limited to the front of the vertebral column, the fracture is usually stable and rarely associated with any nerve or spinal cord damage.
The most common symptoms are sudden onset of back pain, increased pain with standing or walking, relief of pain upon laying down, limited spinal mobility, loss of height—especially in older adults, particularly women, crowding of internal organs, loss of muscle and aerobic conditioning from lack of activity, and deformity. A sudden compression fracture can be very painful, while one that develops gradually may only cause intermittent pain. Fast onset pain following lifting, bending, or falling is typical of compression fracture. For people with advanced osteoporosis, the fracture can even occur with extremely minor activity, such as sneezing, coughing, or even turning over in bed.
In addition to a medical history and physical exam, X-rays, magnetic resonance imaging (MRI), computed tomography (CT) scans, and a nuclear bone scans can confirm a diagnosis.
Surgical options like vertebroplasty and kyphoplasty may be required to stabilize the compression fracture. Vertebroplasty is a minimally invasive treatment to help reduce or eliminate pain and stabilize the bone. Kyphoplasty is also minimally invasive and is designed to reduce or stop the pain caused by a spinal fracture, to stabilize the bone, and to restore some or all of the lost vertebral body height due to the compression fracture. Spinal stabilization and fusion surgery may also be needed to support the spine until the bone heals by placing a bone graft across the area of instability, which allows the vertebrae to fuse.