The type of fracture in the spine that is typically caused by osteoporosis is generally referred to as a compression fracture. Vertebral compression fractures (VCFs) occur when the bony block or vertebral body in the spine collapses, which can lead to severe pain, deformity and loss of height. These fractures more commonly occur in the thoracic spine (the middle portion of the spine), especially in the lower part.
People that have severe osteoporosis, a VCF may be caused by simple daily activities, such as stepping out of the shower, sneezing forcefully or lifting a light object. People with moderate osteoporosis, it can usually take increased force, such as falling down or attempting to lift a heavy object to cause a this pain condition. VCFs are the most common fracture in patients with osteoporosis. The occurrence of this condition increases as people age, with an estimated 40% of women age 80 and older affected by it. Although far more common in women, VCFs are also a health concern for older men.
People who have had one osteoporotic VCF are at five times the risk of sustaining a second VCF. Occasionally, a VCF can be present with either minor symptoms or no symptoms, but the risk still exists for additional VCFs to occur.
People with healthy spines most commonly suffer a VCF through severe trauma, such as a car accident, sports injury or a hard fall.
The main symptoms may include any of the following, alone or in combination:
- Sudden onset of back pain
- An increase of pain while standing or walking
- A decrease in pain while lying on the back
- Limited spinal mobility
- Eventual height loss
- Eventual deformity and disability
Pain secondary to acute vertebral fracture appears to be caused in part by vertebral instability (nonunion or slow-forming union) at the fracture site. VCF-related pain that is allowed to heal naturally can last as long as three months. However, the pain usually decreases significantly in a matter of days or weeks. Traditionally, people with severe pain from VCFs have been treated with reduction in activities other than those which involve caring for yourself, medications, bracing or invasive spinal surgery, often with limited effectiveness. Extended inactivity should be avoided.
Vertebroplasty was introduced in the U.S. in the early 1990s. The procedure is usually done on an outpatient basis, although some patients stay in the hospital overnight. Vertebroplasty takes from one to two hours to perform, depending on the number of vertebrae being treated.