what are compression fractures?
Compression fractures occur when the vertebrae, which are the bones of the spine, break.
Causes
Compression fractures in the back are frequently caused by osteoporosis, a condition where bones become fragile and lose calcium and other minerals with age. These fractures can also result from trauma to the back, tumors that metastasize to the bone, or primary tumors in the spine, such as multiple myeloma.
Symptoms
Compression fractures in the back can occur suddenly, causing severe back pain, most commonly felt in the middle or lower spine, and sometimes in the sides or front. The pain is often sharp and “knife-like,” potentially disabling, and can last weeks to months. Osteoporosis-related compression fractures may initially have no symptoms and are often discovered through X-rays taken for other reasons. Over time, symptoms may develop, such as gradually worsening back pain, height loss (up to 6 inches), and kyphosis (dowager’s hump). This hunched posture can pressure the spinal cord, causing numbness, tingling, weakness, difficulty walking, and loss of bowel or bladder control; however, this is rare.
Treatment
If the cause of compression fractures is osteoporosis, the condition is usually treated with medications and calcium supplements to prevent further fractures. Pain may be managed with pain medicine and bed rest.
Other treatments include using a back brace, which may further weaken bones and increase fracture risk, physical therapy to improve movement and strength around the spine, and calcitonin to relieve bone pain.
Surgery, such as balloon Kyphoplasty, Vertebroplasty, spinal fusion, or tumor-related bone removal, may be necessary if severe, disabling pain persists for more than two months despite other treatments. Post-surgery, patients may need a brace for 6 to 10 weeks if the fracture is injury-related and possibly additional surgery to join spine bones or relieve nerve pressure.
Patient Recovery at Home
Recovery from Kyphoplasty
After a Kyphoplasty procedure, the patient can go home the same day. Arrangements should be made for someone to drive them home. The patient can return to normal activities but should avoid heavy lifting until overall bone health improves. The surgeon will place bandages over the procedure site, which should remain on for two days. The patient may need assistance to remove the bandages when the healthcare provider approves the removal.
Recovery from Vertebroplasty
The patient should rest for 24 hours after the vertebroplasty procedure and avoid strenuous activities for six weeks. Pain relief and improved mobility are often noticed within 48 hours, with some patients experiencing immediate relief. While the patient might feel sore from the procedure, this typically subsides within three days. Applying ice can help relieve soreness at the puncture site.
Recovery from Spinal Fusion
Patients typically remain in the hospital for a few days for observation after surgery. Many can walk on the day of the surgery, although this depends on their age, the extent of the surgery, and the severity of postoperative pain. To provide additional stability while the spine heals, patients may need to wear a back or neck brace for a few weeks post-surgery. In the weeks following surgery, a physical therapist can develop a plan to help build strength and flexibility in the muscles surrounding the spine, enabling the patient to return to their usual activities as soon as possible.
Resources Used
- Surgery for Spine Compression Fractures. (n.d.). Nyulangone.org. https://nyulangone.org/conditions/spinecompression-fractures/treatments/surgery-for-spine-compression-fractures
- Vertebroplasty: What Is It? (n.d.). Cleveland Clinic. https://my.clevelandclinic.org/health/procedures/vertebroplasty
- Kyphoplasty: What Is It? (n.d.). Cleveland Clinic. https://my.clevelandclinic.org/health/procedures/kyphoplasty
(2022). - Pennmedicine.org. https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditionstreated-a-to-z/compression-fracture