Vertebral compression fracture

<h2 id="signs-and-symptoms">Signs and symptoms</h2>
<p>Acute fractures will cause severe <a href="/facts/Back_pain/moP5bWnu">back pain</a>. Compression fractures which develop gradually, such as in osteoporosis, may initially not cause any symptoms, but will later often lead to back pain and loss of height.
</p>
<h2 id="diagnosis">Diagnosis</h2>
<p>Compression fractures are usually diagnosed on <a href="/facts/Spinal_radiograph/pL6JyJEp">spinal radiographs</a>, where a wedge-shaped vertebra may be visible or there may be loss of height of the vertebra. In addition, <a href="/facts/Bone_density_measurement/poUvLR69">bone density measurement</a> may be performed to evaluate for osteoporosis. When a tumor is suspected as the underlying cause, or the fracture was caused by severe trauma, <a href="/facts/X-ray_computed_tomography/NusPJ2S8">CT</a> or <a href="/facts/MRI/Vh9yG9qq">MRI</a> scans may be performed.
</p>

<h2 id="treatment">Treatment</h2>

<h3>Conservative treatment</h3>
<ul><li><a href="/facts/Back_brace/Xf9Cps6Q">Back brace</a> for support while the bone heals—either a Jewett brace for relatively stable and mild injuries, or a thoracic lumbar sacral orthosis (TLSO) for more severe ones.<a class="footnote-ref" id="fnref:4" href="#fn:4"><sup>4</sup></a></li>
<li><a href="/facts/Opioids/EGnE2x99">Opioids</a> or <a href="/facts/Non-steroidal_anti-inflammatory_drug/coIkzl4s">non-steroidal anti-inflammatory drugs</a> (NSAIDs) for pain. For <a href="/facts/Osteoporosis/xa1W00Tj">osteoporotic</a> patients, <a href="/facts/Calcitonin/E0xGEcr5">calcitonin</a> may be helpful.<a class="footnote-ref" id="fnref:5" href="#fn:5"><sup>5</sup></a><a class="footnote-ref" id="fnref:6" href="#fn:6"><sup>6</sup></a></li></ul>
<h3>Surgical</h3>
<ul><li><a href="/facts/Kyphoplasty/fHKwEDGS">Kyphoplasty</a><a class="footnote-ref" id="fnref:7" href="#fn:7"><sup>7</sup></a> and <a href="/facts/Vertebroplasty/fHKwEDGS">vertebroplasty</a><a class="footnote-ref" id="fnref:8" href="#fn:8"><sup>8</sup></a><a class="footnote-ref" id="fnref:9" href="#fn:9"><sup>9</sup></a> are minimally invasive procedures that inject cement into the bone of the back that is fractured. However, the data examining the effectiveness of these procedures is mixed.<a class="footnote-ref" id="fnref:10" href="#fn:10"><sup>10</sup></a><a class="footnote-ref" id="fnref:11" href="#fn:11"><sup>11</sup></a></li></ul>

<h2 id="further-reading">Further reading</h2>

Wikimedia Commons has media related to Compression fractures.

<ul><li>Zeller, J. L.; Burke, A. E.; Glass, R. M. (2008). <a href="https://doi.org/10.1001%2Fjama.299.7.858">"Osteomyelitis"</a>. <i>JAMA</i>. 299 (7): 858. <a href="/facts/Doi_(identifier)/muM9Etpq">doi</a>:<a href="https://doi.org/10.1001%2Fjama.299.7.858">10.1001/jama.299.7.858</a>. <a href="/facts/PMID_(identifier)/JlHAvMHt">PMID</a> <a href="https://pubmed.ncbi.nlm.nih.gov/18285597">18285597</a>.</li>
<li><a href="http://www.medscape.com/viewarticle/477692_3">Medscape article on lytic lesions</a></li>
<li><a href="http://emedicine.medscape.com/article/1157987-overview">Emedicine article on spinal metastasis</a></li></ul>

<h2 id="references">References</h2>

<ol>
<li id="fn:1"><p>Weber, Kristy (February 28, 2006). "Rounds 2: Treatment of Metastatic Bone Disease". Johns Hopkins Arthritis Center. <a href="http://www.hopkins-arthritis.org/physician-corner/cme/rheumatology-rounds/metastatic_bone_disease_rheumrounds2.html" target="_blank">http://www.hopkins-arthritis.org/physician-corner/cme/rheumatology-rounds/metastatic_bone_disease_rheumrounds2.html</a> <a href="#fnref:1" class="footnote-back-ref">↩</a></p></li>
<li id="fn:2"><p>"Bone Infections". MedlinePlus. September 7, 2011. <a href="https://www.nlm.nih.gov/medlineplus/boneinfections.html" target="_blank">https://www.nlm.nih.gov/medlineplus/boneinfections.html</a> <a href="#fnref:2" class="footnote-back-ref">↩</a></p></li>
<li id="fn:3"><p>Brant, William E.; Helms, Clyde A. (2007). "Benign Compression Fracture". Fundamentals of Diagnostic Radiology (3rd ed.). Philadelphia: Lippincott Williams & Wilkins. p. 302. ISBN 978-0-7817-6135-2. <a href="978-0-7817-6135-2" target="_blank">978-0-7817-6135-2</a> <a href="#fnref:3" class="footnote-back-ref">↩</a></p></li>
<li id="fn:4"><p>"Jewett vs. TLSO Replies". OANDP-L on oandp.com. 2010-09-27. Retrieved 2012-09-02. <a href="http://www.oandp.com/oandp-l/message.asp?frmMessageId=73C88D08-3753-4A8A-ADF6-144E33E73564" target="_blank">http://www.oandp.com/oandp-l/message.asp?frmMessageId=73C88D08-3753-4A8A-ADF6-144E33E73564</a> <a href="#fnref:4" class="footnote-back-ref">↩</a></p></li>
<li id="fn:5"><p>"Calcitonin for osteoporotic fractures". Archived from the original on 2009-06-08. Retrieved 2012-09-03. <a href="https://www.webarchive.org.uk/wayback/archive/20090608194055/http://www.medicine.ox.ac.uk/bandolier/booth/painpag/Chronrev/muscskel/CP104.html" target="_blank">https://www.webarchive.org.uk/wayback/archive/20090608194055/http://www.medicine.ox.ac.uk/bandolier/booth/painpag/Chronrev/muscskel/CP104.html</a> <a href="#fnref:5" class="footnote-back-ref">↩</a></p></li>
<li id="fn:6"><p>Knopp, Jennifer A.; Diner, Barry M.; Blitz, Maurice; Lyritis, George P.; Rowe, Brian H. (2004). "Calcitonin for treating acute pain of osteoporotic vertebral compression fractures: A systematic review of randomized, controlled trials". Osteoporosis International. 16 (10): 1281–90. doi:10.1007/s00198-004-1798-8. PMID 15614441. S2CID 34208503. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:6" class="footnote-back-ref">↩</a></p></li>
<li id="fn:7"><p>Taylor, Rod S.; Taylor, Rebecca J.; Fritzell, Peter (2006). "Balloon Kyphoplasty and Vertebroplasty for Vertebral Compression Fractures". Spine. 31 (23): 2747–55. doi:10.1097/01.brs.0000244639.71656.7d. PMID 17077747. S2CID 209491. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:7" class="footnote-back-ref">↩</a></p></li>
<li id="fn:8"><p>Taylor, Rod S.; Taylor, Rebecca J.; Fritzell, Peter (2006). "Balloon Kyphoplasty and Vertebroplasty for Vertebral Compression Fractures". Spine. 31 (23): 2747–55. doi:10.1097/01.brs.0000244639.71656.7d. PMID 17077747. S2CID 209491. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:8" class="footnote-back-ref">↩</a></p></li>
<li id="fn:9"><p>Taylor, Rod S.; Fritzell, Peter; Taylor, Rebecca J. (2007). "Balloon kyphoplasty in the management of vertebral compression fractures: An updated systematic review and meta-analysis". European Spine Journal. 16 (8): 1085–100. doi:10.1007/s00586-007-0308-z. PMC 2200787. PMID 17277923. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2200787" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2200787</a> <a href="#fnref:9" class="footnote-back-ref">↩</a></p></li>
<li id="fn:10"><p>Boonen, S.; Wahl, D. A.; Nauroy, L.; Brandi, M. L.; Bouxsein, M. L.; Goldhahn, J.; Lewiecki, E. M.; Lyritis, G. P.; et al. (2011). "Balloon kyphoplasty and vertebroplasty in the management of vertebral compression fractures". Osteoporosis International. 22 (12): 2915–34. doi:10.1007/s00198-011-1639-5. PMID 21789685. S2CID 19967779. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:10" class="footnote-back-ref">↩</a></p></li>
<li id="fn:11"><p>Han, Shiliang; Wan, Shuanglin; Ning, Lei; Tong, Yongjun; Zhang, Jianfeng; Fan, Shunwu (2011). "Percutaneous vertebroplasty versus balloon kyphoplasty for treatment of osteoporotic vertebral compression fracture: A meta-analysis of randomised and non-randomised controlled trials". International Orthopaedics. 35 (9): 1349–58. doi:10.1007/s00264-011-1283-x. PMC 3167445. PMID 21637959. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3167445" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3167445</a> <a href="#fnref:11" class="footnote-back-ref">↩</a></p></li>
</ol>

Vertebral compression fracture open-in-new

Vertebral compression fracture