Vertebral Compression Fractures
Vertebral compression fractures are widely considered to be the hallmark of osteoporosis. Approximately 30-50% of women and 20-30% of men will suffer from a vertebral compression fracture and half of them will develop multiple fractures. The consequences of vertebral compression fractures are back pain, loss of alignment and occasionally neurological compromise. Vertebral fractures are related to raised mortality well beyond the the first year after fracture.
The WHO recommends all perimenapausal and postmenapausal women undergo bone mineral density screening. The vast majority of vertebral compression fractures can be managed non-operatively, the exceptions being those associated with a neurological deficit or where there is progressive worsening deformity.
A compression fracture is collapse of an individual vertebrae.
Patients typically present with back pain, which may radiate. This pain may be provoked by bending forward, lifting, coughing and respite may be gained from rest or hydrotheraphy.
X-rays and sometimes CT scan may reveal the fracture. Sometimes the fracture is an incidental finding, that is noticed on an X-ray that is done for a separate clinical reason.
Treatment is almost exclusively non-operative, comprising of pain killers and gentle physical therapy.
The evidence supporting vertebroplasty and kyphplasty is mixed and as such is not part of my practice at this stage. I continue to collaborate and participate in research into the scrooge that is osteoporosis and the burden imparted on the individual and the community.