FAQs on Vertebral Compression Fracture
If you are 60 years old or older and have back pain, it could be more than just a normal part of aging. Backache and pain is a sign that there is one or more small fractures of the vertebra, which is called a vertebral compression fracture (VCF). These fractures are often caused by osteoporosis, which are common in postmenopausal woman over age 50.
How common are VCFs?
It is estimated that 10 million Americans suffer from osteoporosis, with another 34 million having low bone mass (osteopenia). VCF is the most common type of fracture for people with osteoporosis, occurring in women more than men at a ratio of 4:1. VCFs affect around 25% of all postmenopausal women, reported in 40% of women age 80 and older.
What causes a vertebral compression fracture?
A VCF occurs when the vertebral body of the spine collapses. These fractures occur most often in the middle portion of the spine (thoracic region), particularly the lower part. These fractures are caused mainly by trauma, metastatic tumors, and osteoporosis. VCFs can occur from something as simple as stepping out of the shower or sneezing in someone who has severe osteoporosis. In the healthy spine, VCF mainly is the result of a car accident, hard fall, or other types of trauma.
Who is at risk for VCF?
Two main groups of individuals are at the highest risk for spinal vertebral compression fractures: people with bone weakness due to osteoporosis and those with bone cancer. Other risk factors include:
- Age – The risk increases rapidly in women over 50.
- Race – White and Asian women are at greatest risk.
- Weight – Thin women have a higher incidence of VCF.
- Early menopause – Going through menopause before the age of 50 years.
- Smoking – Smoking causes bone loss.
How is VCF treated?
- Medications – There are many nonsteroidal anti-inflammatory drugs (NSAIDs) recommended for back pain. Muscle relaxants and opioid pain medicines may be prescribed short-term. For osteoporosis, bone-strengthening drugs are used to restore and stabilize bone loss, such as Actonel and Fosamax.
- Back bracing – A back brace gives external support to the fractured vertebra(e) and limits mobility, allowing the spine to heal. Braces are used in caution and under a doctor’s supervision, because they can lead to loss of muscle and strength with excessive use.
- Physical therapy – One the fracture is confirmed, and after a period of bedrest, the doctor may order physical therapy, which includes heat, ultrasound, and massage. This relieves the pain of VCF.
- Vertebroplasty – With this procedure, a needle is inserted into the damaged vertebrae, and bone cement is injected into the fracture. The needle is removed, and the cement hardens within 10 minutes. In a study involving more than 650 individuals, significant improved mobility and pain relief was reported following vertebroplasty.
- Kyphoplasty – To correct bone deformity and relieve pain, a tube is inserted through the skin into the damaged vertebra, and a balloon at the tip is guided into the fractured area. The balloon is inflated to create a cavity, and liquid cement is then injected. The balloon is removed and the cement hardens within 10 minutes. In one large clinical study of patients older than 65 years, kyphoplasty was found to be extremely effective for VCF due to myeloma.