What is a compression fracture?
A vertebra is a block of bone carrying load. When that bone is weakened, most often by osteoporosis, it can collapse at the front, wedging into a slight forward angle. This happens most frequently in the mid-back and upper lumbar spine, and often with little or no injury.
Symptoms
- Sudden, sharp back pain at a specific spot, often traceable to a moment
- Pain that is worse standing or walking and eases lying flat
- Tenderness directly over the affected level
- Pain on coughing, sneezing, or rolling over in bed
- Gradual loss of height or increasing forward curve after repeated fractures
Urgent
Come in promptly if you develop numbness or weakness in the legs, a band of numbness around the trunk, or any change in bowel or bladder control, those suggest the fracture is affecting the spinal cord or nerves.
How it is diagnosed
X-rays usually show the collapse and its degree. MRI distinguishes a recent fracture that is still healing from an old one, which changes the treatment, and helps exclude other causes of vertebral collapse. A bone density scan and a workup for the underlying cause are an important part of the assessment rather than an afterthought.
Non-surgical treatment
Most compression fractures heal without an operation. Management focuses on pain control adequate to keep you moving, a brief period of activity modification, bracing in selected cases, and early attention to bone health, calcium, vitamin D, and medical treatment of osteoporosis where indicated. Physical therapy follows once pain allows.
When surgery is considered
Kyphoplasty may be considered when pain remains severe and disabling despite appropriate non-operative care, particularly when the fracture is recent and still healing on MRI. It stabilizes the vertebra through a needle-sized opening. Larger reconstruction is reserved for fractures causing instability, deformity, or pressure on the nerves.