Vertebral Fracture: Causes, Symptoms, Treatment, and Prevention
What is a Vertebral Fracture?
A vertebral fracture refers to a break or crack in one of the vertebrae, the small bones that make up the spine. These fractures can occur in any part of the spine and range from mild to severe. Vertebral fractures can be caused by various factors, including trauma, osteoporosis, tumours, or certain medical conditions that weaken the bones.
Types of Vertebral Fracture
- Compression Fracture: This is the most common type and typically occurs in the front of the vertebra, causing it to collapse. It’s often associated with osteoporosis or traumatic injury.
- Burst Fracture: This fracture involves the entire vertebra, causing it to collapse and deform due to high-energy trauma, like a fall from a height or a car accident.
- Flexion Distraction Fracture: This type often occurs in high-speed accidents and is characterised by the vertebra being pulled apart due to forceful forward flexion of the spine.
How Common is Vertebral Fracture?
Vertebral fractures, particularly compression fractures, are relatively common, especially among the elderly or those with weakened bones, such as individuals with osteoporosis.
Causes of Vertebral Fracture
Various factors can cause vertebral fractures, and the causes often differ based on the fracture type. Some common causes include:
- Osteoporosis: One of the most common causes of vertebral fractures, especially compression fractures, is osteoporosis. Weakening of the bones due to osteoporosis makes them more susceptible to fractures, even with minor stress or pressure on the spine.
- Trauma: Accidents, falls, and high-impact injuries, such as those sustained in motor vehicle accidents or significant falls, can lead to vertebral fractures. These accidents can cause different fractures, including burst fractures or flexion distraction fractures.
- Repetitive Stress: Over time, repeated stress or strain on the spine due to certain activities or occupations can weaken the vertebrae, making them more prone to fractures. This can be seen in individuals involved in heavy lifting, certain sports, or jobs that involve repetitive bending and twisting of the spine.
- Tumours: Cancerous tumours that affect the spine can weaken the bone structure, making vertebrae more susceptible to fractures.
- Bone Diseases and Conditions: Conditions like osteogenesis imperfecta (a genetic disorder causing fragile bones), certain infections affecting the spine, or metabolic bone diseases can increase the risk of vertebral fractures.
- Osteopenia: A condition where bone mineral density is lower than normal but not low enough to be classified as osteoporosis. This can increase the risk of fractures, including vertebral fractures.
Symptoms of Vertebral Fracture
Symptoms of a vertebral fracture can vary depending on the severity and location of the fracture. Some individuals might experience no symptoms, while others may have noticeable signs. Common symptoms include:
- Sudden Back Pain: Pain in the back is a typical symptom, especially in the area where the fracture occurred. The pain might range from mild to severe and can be sharp, dull, or throbbing.
- Decreased Height: Vertebral fractures, particularly compression fractures, can cause a loss in height due to the collapse of the affected vertebra, resulting in a stooped or hunched posture.
- Limited Mobility: Pain and discomfort can limit movement, especially bending or twisting of the spine.
- Radiating Pain: Pain might radiate around the ribs or abdomen if the fractured vertebra compresses nearby nerves.
- Numbness or Tingling: Some individuals might experience sensations like numbness or tingling, especially if the fracture is affecting nearby nerves.
- Difficulty Breathing: In more severe cases where the fractured vertebra impinges on the spinal cord or surrounding nerves, it could cause difficulty in breathing or other neurological symptoms.
- Spinal Deformities: Severe vertebral fractures, particularly in the case of multiple fractures or certain fracture types, can lead to spinal deformities such as kyphosis, characterised by an exaggerated rounding of the upper back.
Diagnosis of Vertebral Fracture
Diagnosing a vertebral fracture typically involves a combination of medical history review, physical examination, and imaging studies. Here are the steps involved in the diagnosis:
Diagnosis of Vertebral Fracture
The orthopaedic specialist will discuss your symptoms, any recent trauma or incidents that might have led to the injury, and any relevant medical history, including conditions such as osteoporosis or cancer that might affect bone health.
A physical examination involves assessing your spine for tenderness and deformities and your range of motion. The doctor will check for areas of pain and tenderness, looking for signs that could indicate a vertebral fracture.
X-rays are commonly used to confirm the presence of a vertebral fracture. X-rays can show the location and extent of the fracture, as well as any potential misalignment or collapse of the vertebra.
In some cases, additional imaging studies such as MRI (Magnetic Resonance Imaging) or CT (Computed Tomography) scans might be recommended to get a more detailed view of the fracture, surrounding structures, and potential nerve involvement.
Bone Density Testing
If osteoporosis is suspected, bone density testing (DEXA scan) might be performed to assess bone strength and the risk of fractures due to bone loss.
Complications of Vertebral Fracture
Vertebral fractures can lead to various complications, especially if left untreated or if they affect the stability of the spine. Some potential complications include:
- Chronic Pain: Even after the initial healing of the fracture, some individuals might experience long-term, persistent back pain.
- Spinal Deformities: Severe vertebral fractures, especially compression fractures, can change the spine’s shape and alignment, leading to conditions like kyphosis, where the spine appears hunched or rounded.
- Loss of Height: Multiple vertebral fractures, particularly in individuals with osteoporosis, can cause a reduction in height due to the collapse of multiple vertebrae.
- Reduced Mobility: Fractures and resulting pain can limit a person’s ability to move, bend, or twist comfortably.
- Neurological Complications: In severe cases where the fracture compresses the spinal cord or nerves, it can lead to symptoms such as numbness, tingling, weakness, or even loss of bladder or bowel control.
- Prolonged Disability: Severe fractures that don’t heal properly or lead to chronic pain might result in prolonged disability or difficulty in performing daily activities.
- Increased Risk of Additional Fractures: One vertebral fracture can increase the risk of subsequent fractures, especially if the underlying cause, such as osteoporosis, is not properly managed.
Treatment Options for Vertebral Fracture
Treatment for vertebral fractures can vary depending on the severity of the fracture, the symptoms experienced, and the underlying cause. Here are some common treatment options:
Initially, over-the-counter or prescription pain medications may be used to alleviate discomfort. Rest and avoiding activities that exacerbate pain can also be advised.
A back brace or orthosis may be recommended to provide support and stability to the spine, especially in compression fractures or to assist in pain relief during the healing process.
Rehabilitation exercises can be beneficial to improve strength, flexibility, and posture, as well as to reduce pain and prevent further complications.
Vertebroplasty or Kyphoplasty
In severe pain due to compression fractures, minimally invasive procedures such as vertebroplasty or kyphoplasty might be considered. These involve injecting bone cement into the fractured vertebra to stabilise and support it.
For severe fractures or cases where conservative measures aren’t effective, surgery might be recommended. Surgical procedures may involve spinal fusion, instrumentation, or stabilisation to address the fracture and restore spinal stability.
If osteoporosis is the underlying cause of the fracture, treatment to improve bone density and strength, such as medications, supplements, and lifestyle modifications, will be essential to prevent future fractures.
Preventing Vertebral Fracture
Preventing vertebral fractures involves various measures focused on strengthening bones and minimising the risk of injury. Here are some preventive strategies:
- Ensure adequate calcium and vitamin D intake through a balanced diet and supplements if necessary.
- Engage in weight-bearing activities like walking or resistance training to strengthen bones.
- Maintain clear and safe surroundings to avoid falls, using handrails and non-slip mats when needed.
- Work with an orthopaedic specialist to manage osteoporosis effectively through medication and lifestyle changes.
- Use proper lifting techniques and avoid high-risk activities to protect your spine.
- Consider bone density tests to assess bone strength and fracture risk.
- Regularly consult orthopaedic specialists, especially if you’re at risk for fractures.
- Limit alcohol intake and avoid smoking to maintain better bone health.
Living with Vertebral Fracture
Living with a vertebral fracture can be challenging, but there are ways to manage and improve your quality of life:
- Follow prescribed pain relief strategies and techniques to alleviate discomfort. Work with orthopaedic specialists to manage pain effectively.
- Engage in recommended exercises or physical therapy to improve strength, flexibility, and overall spine health. Avoid high-impact activities that might worsen the condition.
- Maintain proper posture and use good body mechanics to reduce strain on the spine. Lift and move objects carefully, using proper techniques to avoid aggravating the fracture.
- If necessary, consider using assistive devices like braces or walking aids to support the spine and aid mobility.
- Follow prescribed medications and treatment plans orthopaedic specialists provide to promote healing and prevent further complications.
- Implement lifestyle changes that promote bone health, including a nutritious diet rich in calcium and vitamin D, avoiding smoking, and limiting alcohol intake.
- Maintain regular check-ups with orthopaedic specialists to monitor the healing process, ensure proper recovery, and address any concerns.
Living with a vertebral fracture can be challenging, but by adopting a proactive approach and seeking proper care, it’s possible to manage the condition effectively. Strategies such as pain management, exercise, lifestyle modifications, and regular medical follow-up can greatly improve one’s quality of life while healing from a vertebral fracture.
At The Orthopaedic Practice and Surgery Clinic, our team specialises in diagnosing and treating vertebral fractures. We provide tailored treatment plans and support for effective recovery. If you suspect a vertebral fracture or experience related symptoms, taking the step to seek professional evaluation is crucial.
Don’t let a vertebral fracture hinder your well-being. Request an appointment with our clinic today to begin your journey toward recovery and improved spinal health. Your comfort and recovery are our priority. Contact us for a consultation to receive specialised care and support for your vertebral fracture.