When there is a fracture of the spine or if one of the vertebrae bones is broken due to a compressive force, it is known as compression fracture of the spine. Lower back is the most common site for this type of fractures as the vertebrae of the lower back have to bear the extra weight of the vertebrae present above.
Causes of Compression Fracture of the Spine
- Compression fractures occur due to a compressive force to the spine such as during traumatic injury e.g. landing on the buttocks or feet after falling from a great height.
- Bone disorders such as osteoporosis predispose a person to this type of fracture. It is more common in aged people or individuals with pre-existing spinal problems causing weakness of the bone.
- Other pre-existing conditions such as bone cancer may also result in fracture.
- Bone infection such as osteomyelitis may also predispose a patient to a fracture.
- In case of weakening of the bone, the vertebra is compressed under the weight of the vertebra located above leading to thinning of the bone and resulting in a fracture.
- Compression fractures may also result from car accidents.
- Patients with compound compression fractures usually have a bent over posture as the vertebrae bears their weight at the front resulting in compression at the front and retain the same shape at the back.
- Nerves may be involved in degenerative and traumatic compression fractures due to the closeness of the nerve roots and the spinal cord.
Symptoms of a Compression Fracture of the Spine
- Pain at the site of the fracture, usually in the lower back.
- Patient may also have pain in the hips, buttocks or thighs.
- Numbness, tingling and weakness indicate compression of the nerves.
- Bladder or bowel incontinence or inability to pass urine is an indication that the fracture is also compressing the spinal cord.
Different Treatment Options for Compression Fracture of the Spine
Traumatic Compression Fractures
- If there is severe pain, high fever, numbness and tingling then immediate medical attention should be sought.
- An X-ray, MRI or a CT scan helps in confirming the diagnosis.
- Traumatic compression fractures often require surgery to attach the vertebrae back together and to prevent slippage and further injury to the spinal cord.
Degenerative Compression Fractures
- Rest should be taken from aggravating activities.
- Patients with osteoporosis should start weight bearing exercises and increase their calcium intake.
- Initially ice therapy can be applied to the fractured site to relieve pain and later on heat therapy can be used.
- Back brace should be used.
- Stretching and strengthening exercise should be undertaken by patients suffering from osteoporosis in order to strengthen muscles which support the back.
- NSAIDs such as ibuprofen and naproxen, narcotics such as hydrocodone, muscle relaxants such as diazepam can be given for pain relief.
- Surgery may be required in case of a vertebral collapse.
- Vertebroplasty may be performed in which bone cement is injected into the fractured vertebra to steady the fracture, decrease the pain and to re-establish the bone height.