What Causes Compression Fractures of the Spine and How Are They Treated?

Understanding Compression Fractures of the Spine

A compression fracture is a type of break that occurs in the vertebrae, which are the bones making up the spine. This fracture typically results from excessive pressure on the vertebral body, often arising from a blend of bending forward combined with downward pressure on the spine. When a portion of a vertebra collapses, it is termed a compression fracture.

Each bone of the spine, or vertebra, consists of two main sections:

The Vertebral Body: This is the block-like portion of the vertebra and forms the main structure of the spinal column.
The Vertebral Arch: This is a ring-shaped section that shields the spinal cord by forming the roof of the spinal canal.

Compression fractures often manifest in the bottom region of the thoracic spine, notably around T11 and T12, and the first vertebra of the lumbar spine, L1. There are various causes of these fractures. For instance, osteoporosis is the most prevalent cause, but other causes encompass spinal injuries and tumors. Additionally, trauma, such as motor vehicle accidents or significant falls, can lead to burst fractures, which account for approximately 14% of all spinal injuries.

Identifying Compression Fractures

Diagnosing a compression fracture involves various imaging techniques. For example, a sagittal T1-weighted MR image might reveal compression fractures with specific indicators like retropulsion of a bone fragment. It’s common for specialists to recommend CT and MRI scans for a more detailed assessment. At times, the visibility of some posterior element structures might be limited, necessitating specialized views.

Treatment and Prevention

Treating and preventing osteoporosis stands out as the most effective strategy to reduce the risk of compression fractures. However, when vertebral compression fractures persistently cause pain despite conservative measures such as bed rest, pain medications, or wearing a back brace, other treatments may be warranted. Interventional procedures, such as vertebroplasty, are sometimes recommended, especially for patients who cannot tolerate pain medications, those with compromised bone healing, or those affected by malignant tumors or other underlying conditions.

In conclusion, compression fractures of the spine can be intensely painful and debilitating. However, understanding their causes and seeking timely medical intervention can significantly aid recovery and improve quality of life.

Becker