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Vertebral Compression Fracture

What is a vertebral compression fracture?

A vertebral compression fracture (VCF) is a break in a part of the vertebra. Vertebrae are the round, strong bones that form your spine. VCFs most often occur in the thoracic (middle) and lumbar (lower) areas of your spine. Fractures may be mild to severe.

What causes a VCF?

  • Osteoporosis is a condition that causes your bones to become weak and brittle. People with weak bones can get fractures by bending forward, standing from a seated position, sneezing, or strong coughing.

  • Injuries to the spine can occur during a vehicle accident, a fall, or while playing sports.

  • Diseases of the spine, such as cancer, infection, and avascular necrosis, can weaken your bones and cause fractures.

What are the signs and symptoms of a VCF?

You may not have any signs and symptoms with a mild VCF, or you may have any of the following:

  • Sudden, severe, and sharp back pain

  • Back pain that gets worse when you stand or walk

  • Muscle spasms in your back

  • Problems urinating or having bowel movements

  • Sudden weakness in your arms or legs

How is a VCF diagnosed?

Your healthcare provider will ask you about injuries and diseases you have had in the past. Your healthcare provider will do a physical exam, and check your spine. You may need any of the following tests:

  • X-rays, a CT scan, or MRI of your spine may be taken. You may be given a dye before the pictures are taken to help healthcare providers see the pictures better. Tell the healthcare provider if you have ever had an allergic reaction to contrast dye. You should not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.

  • A bone scan of your spine may be done. The pictures may show broken bones or other problems in the spine, such as an infection.

How is a VCF treated?

If you have a mild fracture, you may need to rest in bed for a short time. You may need to wear a back brace for 8 to 12 weeks. A brace may decrease your pain, and help your vertebrae heal. You may need to use a cane or walker. You may also need any of the following:

  • Medicines:

    • NSAIDs help decrease swelling and pain or fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask if NSAIDs are safe for you. Always read the medicine label and follow directions. Do not give these medicines to children under 6 months of age without direction from your child's doctor.

    • Acetaminophen decreases pain and fever. It is available without a doctor's order. Ask how much to take and how often to take it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.

    • Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely.

    • Bisphosphonates and calcitonin may be recommended to help your bones get stronger. They can decrease the pain of a VCF caused by osteoporosis, and decrease your risk for another fracture.

  • Physical and occupational therapy may be recommended. A physical therapist teaches you exercises to help improve movement and strength, and to decrease pain. An occupational therapist teaches you skills to help with your daily activities.

  • Surgery may be needed if your pain, weakness, or numbness does not go away after other treatments. Surgery may make your spine more stable, and help decrease pressure on your spinal nerves caused by the fracture.

    • Vertebroplasty is a procedure used to place bone cement into the fractured vertebrae.

    • Kyphoplasty is a procedure that uses a balloon to make a space in the fractured vertebrae. Bone cement is then put inside the space made by the balloon.

    • Open surgery returns bones to the right place and holds them together with wires, pins, plates, or screws.

How can I manage pain while I sleep?

  • Do not sleep in a waterbed. Waterbeds do not provide good back support.

  • Sleep on a firm mattress. You may also put a ½ to 1-inch piece of plywood between the mattress and box spring.

  • Sleep on your back with a pillow under your knees. This will decrease pressure on your back. You may also sleep on your side with 1 or both of your knees bent and a pillow between them. It may also be helpful to sleep on your stomach with a pillow under you at waist level.

When should I contact my healthcare provider?

  • You are not hungry, and you are losing weight.

  • You cannot sleep or rest because of back pain.

  • You have pain or swelling in your back that is getting worse, or does not go away.

  • You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

  • You feel lightheaded, short of breath, and have chest pain.

  • You cough up blood.

  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.

  • You have new problems urinating or having bowel movements.

  • You have severe pain in your back after falling, bending forward, sneezing, or coughing strongly.

  • You suddenly cannot feel your legs.

  • You suddenly have trouble moving your arms or legs.

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. 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.

© 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.

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