Vertebral Compression Fracture

WHAT YOU SHOULD KNOW:

  • A vertebral compression fracture (VCF) is when one or more bones of your vertebrae collapse. Vertebrae are round, strong bones stacked on one another. Thirty-three of these bones make up your spine. Your spine goes down the middle of your back. Compression fractures of the spine happen when there is too much pressure on the vertebra. These fractures may be caused by injuries or diseases of the spine, and osteoporosis (weak bones). Older age, certain medicines, and having low bone mineral density may increase your risk for VCF. Eating a diet low in calcium and vitamin D, smoking, and drinking alcohol also increases your risk. These fractures happen most often in the thoracic (middle), and lumbar (lower) parts of your spine.

  • You may have sudden, severe, sharp back pain after an injury. You may have pain that gets worse when standing or walking, and goes away when you stop moving. Chronic (long-term) VCF can cause mild back pain, height loss, shortness of breath, and trouble climbing stairs. You may also get kyphosis (rounded back), or lordosis (abnormal back curve). You may need x-rays, magnetic resonance imaging (MRI), or computerized tomography (CT) scan to help find your VCF. Bed rest, pain medicine, and a back brace may be used to treat mild VCF. Using a heat pad or ice pack on your back, changing your diet, and getting exercise may help decrease your pain. If your pain does not go away, treatments such as vertebroplasty, kyphoplasty, or open surgery may be done. When a vertebral compression fracture is found and treated, your pain may decrease or go away.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • You may be allergic to your pain medicine. Pain medicine may also cause problems with your stomach, kidneys, and heart. Hormone medicine may increase a woman's risk for heart disease, breast cancer, and stroke. If you have surgery, you could bleed too much, or get an infection. Your spinal cord or other parts of your spine may be injured. After surgery, cement may leak and cause numbness, problems moving your arms or legs, and more fractures. Even with treatment, signs and symptoms of a vertebral compression fracture may come back.

  • You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs. A blood clot in your lungs can cause chest pain and trouble breathing. This problem can be life-threatening.

  • If your fracture is not treated, your back may slope or bend more, and you may be unhappy with how you look. You may become short of breath, and be at a higher risk of falling. The pain may get worse, and stop you from doing things you enjoy. Your spinal cord may be squeezed or damaged, causing you to lose feeling and movement. You may get bed sores from being in bed for a long time. This can cause problems with your heart, intestines, lungs, and brain. Ask your caregiver if you are worried or have questions about your condition, care, or treatment.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Medicines:

You may be given the following medicines:

  • Bisphosphonates: This medicine can help you keep the bone strength that you have, and may help your bones get stronger.

  • Calcitonin: This medicine helps strengthen your bones. It can decrease the pain of a VCF when it is caused by osteoporosis. It can also decrease your risk of getting another fracture.

  • Hormones: Parathyroid hormone may be given to certain women to increase bone density, and decrease the risk of fractures. Certain women may be given the hormone estrogen to treat osteoporosis. Medicine called estrogen receptor modulators increase bone density and can help prevent fractures.

  • Nonsteroidal anti-inflammatory medicine: This family of medicine is also called NSAIDs. Nonsteroidal anti-inflammatory medicine may help decrease pain and swelling.

  • Pain medicines: You may be given medicine to decrease the pain caused by a compression fracture. Medicine may be given regularly, or may only be given if you ask caregivers for it. You may get this medicine through an IV, which is a small tube placed in your arm. Tell caregivers if your pain does not decrease enough for you to feel better. Do not wait to ask for your pain medicine until the pain is very bad. The medicine may not work as well at controlling your pain if you wait too long to take it. Ask your caregiver for help getting out of bed if you feel tired or dizzy.

  • Supplements: You may be given calcium and vitamin D to help strengthen your bones.

Activity:

  • Bedrest: You may need to rest in bed for a short time. Caregivers may use radiotherapy, heat or ice packs, or massage to decrease your pain.

  • Occupational therapy: A caregiver will work with you using work, self-care, and other activities to help you in your daily life. Occupational therapy (OT) teaches special skills for bathing, dressing, cooking, eating, and driving. A caregiver may help you choose tools to use, and suggest ways to keep your home or workplace safe.

  • Physical therapy: You may need to see a physical therapist to teach you special exercises. These exercises help improve movement and decrease pain. Physical therapy can also help improve strength and decrease your risk for loss of function.

Tests:

You may have any of the following:

  • Bone scan: This is a test to look at your spine. Caregivers can look at the pictures for broken bones.

  • Computed tomography scan: This is also called a CT scan. It is a type of x-ray that uses computers to take pictures of your spine.

  • Magnetic resonance imaging: This test is also called an MRI. During the MRI, pictures are taken of your spine using magnetic waves. You will need to lie still during a MRI. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. This can cause serious injury.

  • Positron emission tomography scan: This test is also called a PET scan. A PET scan shows how much blood and oxygen is flowing to an area of your spine.

Treatment options:

  • Surgery: You may need surgery if your pain, weakness, or numbness does not go away with other treatments. Surgery may be done to make your spine more stable, and help decrease pressure on spinal nerves caused by the fracture. This may include any of the following:

    • Vertebroplasty: Bone cement is placed into the fractured vertebrae.

    • Kyphoplasty: A balloon is placed in the fractured vertebrae. Bone cement is put inside the space made by the balloon.

    • Open surgery: Open surgery returns bones to the correct place by putting them together using wires, pins, plates, or screws.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Vertebral Compression Fracture (Inpatient Care)

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