Fractures

When Back Pain is a Spine Compression Fracture

The type of fracture in the spine that is typically caused by osteoporosis is generally referred to as a compression fracture.

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 compression fractures can occur in vertebrae anywhere in the spine, but they tend to occur most commonly in the upper back (thoracic spine), particularly in the lower vertebrae of that section of the spine (e.g. T10, T11, T12). They rarely occur above the T7 level of the spine. They often occur in the upper lumbar segments as well, such as L1.

This article provides in-depth information on vertebral compression fractures, including symptoms, diagnosis, and treatments.

Types of Fractures

A spinal fracture due to osteoporosis (weak bones) is commonly referred to as a compression fracture, but can also be called a vertebral fracture, osteoporotic fracture, or wedge fracture.

The term "wedge fracture" is used because the fracture usually occurs in the front of the vertebra, collapsing the bone in the front of the spine and leaving the back of the same bone unchanged. This process results in a wedge-shaped vertebra. A wedge compression fracture is generally a mechanically stable fracture pattern.

While wedge fractures are the most common type of compression fracture, there are other types as well, such as:

Crush fracture - If the entire bone breaks, rather than just the front of the vertebra, it may be called a crush fracture.

Burst fracture - This type of fracture involves some loss of the height in both the front and back walls of the vertebral body (rather than just the front of the vertebra). Making this distinction is important because burst fractures can be unstable and result in progressive deformity or neurologic compromise.

Compression Fracture Symptoms

Vertebral fractures are usually followed by acute back pain, and may lead to chronic pain, deformity (thoracic kyphosis, commonly referred to as a dowager's hump), loss of height, crowding of internal organs, and loss of muscle and aerobic conditioning due to lack of activity and exercise.

A combination of the above problems from vertebral fractures can also lead to changes in the individual's self-image, which in turn can adversely affect self-esteem and ability to carry on the activities of daily living.

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.

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