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Compression Fracture

A compression fracture is a type of fracture that occurs when a bone, typically a vertebra in the spine, collapses or is compressed. Compression fractures can result from various causes and may lead to pain, deformity, and impaired mobility. Understanding the symptoms and treatment options is essential for effective management and optimal outcomes.

Causes of Compression Fractures

Osteoporosis

Osteoporosis, a condition characterized by weakened and porous bones, is one of the most common causes of compression fractures, particularly in older adults. Reduced bone density and strength increase the risk of vertebral compression fractures, even with minimal trauma or stress on the spine.

Trauma or Injury

Traumatic events, such as falls from heights, motor vehicle accidents, or sports injuries, can cause compression fractures by exerting excessive force on the spinal vertebrae. High-impact trauma may result in vertebral compression fractures, especially in individuals with pre-existing bone disorders or weakened spinal structures.

Diseases

Diseases, including bone tumors, metastatic cancer, multiple myeloma, and spinal infections (e.g., osteomyelitis), can weaken bone tissue and predispose individuals to compression fractures. Tumors and infections may infiltrate the vertebral body, compromising its structural integrity and increasing the risk of fracture.

Symptoms of Compression Fractures

Back Pain

Back pain is the most common symptom of compression fractures, typically localized to the affected region of the spine. Pain may range from mild to severe and may worsen with movement, standing, or weight-bearing activities.

Loss of Height

Compression fractures can lead to a decrease in overall height due to vertebral collapse and loss of vertebral body height. Individuals may notice a reduction in their stature or a stooped posture as a result of multiple compression fractures.

Limited Mobility

Compression fractures may restrict spinal mobility and range of motion, making it difficult to bend, twist, or perform daily activities. Reduced mobility may impact functional independence and quality of life, especially in older adults with multiple vertebral fractures.

Neurological Symptoms

Severe compression fractures or fractures involving the spinal cord may cause neurological symptoms, such as weakness, numbness, tingling, or difficulty controlling bowel or bladder function. Neurological deficits require immediate medical attention to prevent further neurological impairment.

Treatment Options for Compression Fractures

Conservative Management

Conservative management is often the initial approach for treating compression fractures, especially in stable fractures without neurological compromise. Bed rest, pain management with analgesic medications (e.g., acetaminophen, nonsteroidal anti-inflammatory drugs), and activity modification may be recommended to alleviate symptoms and promote healing.

Bracing

External bracing with a thoracolumbar orthosis (TLSO) or a custom-fitted spinal brace may be prescribed to provide support and stabilization to the spine during the healing process. Bracing helps reduce pain, prevent further vertebral collapse, and promote proper alignment of the fractured vertebrae.

Physical Therapy

Physical therapy plays a crucial role in the rehabilitation of compression fractures, focusing on strengthening the muscles surrounding the spine, improving posture, and enhancing spinal stability. Therapeutic exercises, stretching techniques, and postural correction strategies help restore spinal function and prevent recurrent fractures.

Vertebroplasty or Kyphoplasty

Vertebroplasty and kyphoplasty are minimally invasive surgical procedures used to stabilize vertebral compression fractures and alleviate pain. During vertebroplasty, bone cement is injected into the fractured vertebra to restore vertebral height and enhance structural integrity.

Kyphoplasty involves the insertion of a balloon-like device into the collapsed vertebra, followed by inflation to create space for bone cement injection and vertebral augmentation.

Surgery

Surgical intervention may be considered for severe or unstable compression fractures associated with spinal instability, neurological compromise, or refractory pain. Surgical procedures, such as spinal fusion, vertebral augmentation, or instrumentation, may be performed to restore spinal alignment, decompress neural structures, and stabilize the spine.

Conclusion

Compression fractures are common orthopedic injuries that can cause significant pain, functional impairment, and reduced quality of life, especially in older adults and individuals with underlying bone disorders. Prompt diagnosis, appropriate treatment, and comprehensive rehabilitation are essential for optimizing outcomes and preventing long-term complications.