Compression Fractures

Many people have compression fractures. Compression fractures are a type of fracture that occurs in the body of a spinal vertebra. The body of a spinal vertebra is the large square-like portion of bone in the front. In a compression fracture, the vertical portion of the vertebral body collapses or compresses downward. This results in a loss of bone height. The bony articular pillars in the rear of a vertebral segment continue to provide stability and support, therefore, compression fractures typically result in a forward triangular wedge. As a result, this leads to a forward tilt or lean in the spine. These compression fractures occur more frequently in the mid and low back where the spine has to manage more body weight and force, but can occur at any vertebral segment.

Compression fractures where the vertebra compresses down only in the front are stable. Compression fractures can be uncomfortable and painful, but often there is little discomfort. Many people with compression fractures don’t experience significant symptoms, even when multiple compression fractures are present. This can make compression fractures difficult to identify. Burst fractures are another type of vertebral body fracture. These fractures occur when the sides of a vertebra fracture and push outward. Unlike compression fractures, burst fractures are typically unstable.

There are a variety of causes for these compression fractures. Trauma can be a cause of compression fractures, particularly when the bones are already weakened from decreased calcium and osteoporosis. Injuries sustained in an auto accident are an example where the force of a collision places an increased load on the spine and can cause weakened bones to fracture.

Osteoporosis can lead to compression fractures with daily activities that would otherwise be trivial. For example, someone with severe osteoporosis may experience a compression fracture when reaching, coughing, or sneezing.

Compression fractures can also have a genetic link. Some people are prone to compression fractures in middle age, and often suffer from multiple compression fractures. Multiple compression fractures in a row can produce a forward lean or hunch in the spine. Compression fractures tend to affect women more than men. While bone density decreases with age in both men and women, the rate of bone density loss especially increases in women after menopause.

Some people suffer from multiple compression fractures. Each compressed vertebral segment causes the body to lean further forward. From the outside, this can appear to be a stooped forward or hunchbacked appearance. The forward lean from a compression fracture moves the center of gravity forward, which leverages additional force on the spine. Further force on the spine is added as the muscles of the back have to work harder to balance the increased forward force due to leverage and keep the body upright. This additional force can cause other spinal vertebra to suffer from compression fractures, further increasing forward tilt and pressure on adjacent vertebra. In this way multiple spinal compression fractures can and often occur.

As we have discussed, the cause of many compression fractures is related to low bone density. Even in the case of genetically associated compression fractures, low bone density in the vertebral bodies is a factor. Supplements and medications that help increase calcium absorption and bone density are available. Calcium is the major component that contributes to bone strength, and supplementation with calcium can help. Vitamin D helps increase calcium absorption and deposition into the bones. Without sufficient Vitamin D, calcium may be available in the diet, but unavailable for deposition into the bones. DEXA scans can be used to determine bone calcium levels, evaluate risk of fractures, and assist in identifying treatment options.

Vertebroplasty and Balloon Kyphoplasty are surgical procedures that are available to treat compression fractures. Vertebroplasty involves injecting a cement into the collapsed vertebral body to stabilize the vertebra, decrease pain, and prevent further collapse and compression. The hardened cement provides strength and support that helps prevent future compression fractures.

Balloon Kyphoplasty is a similar procedure. In Balloon Kyphoplasty, a balloon is placed into the collapsed vertebra and filled with cement. This provides the strengthening benefit of vertebroplasty, but is able to lift the vertebra back to its original position. This restores the vertebral height and shape preventing kyphosis, or forward lean of the spine that results from compression fractures.

Bones quickly begin to heal after an injury. Vertebroplasty and Balloon Kyphoplasty need to be performed early after a compression fracture has occurred before the vertebra heal in the compressed position.

Symptoms of compression fractures can be vague and similar to many other conditions. Your Chiropractor will be able to evaluate for compression fractures and provide treatment to address pain and discomfort. Your Chiropractor will be able to advise you on supplements that can help improve bone density and reduce the risk of compression fractures. Contact your Chiropractor if you have discomfort in the back or have been injured in an auto accident.