A Vertebral Compression Fracture (VCF) is the collapse or breakdown of a bone or bones in the back. These fractures occur most often in the middle and lower parts of the spine, also called the thoracic and lumbar regions. The vertebrae are the bones of the back that make up the spine. They stack on top of each other and protect the spinal cord. Compression fractures occur when there is too much weight put on the spine. Fractures can range from mild to severe.
What are the Principal Causes of VCF?
The most common risk factor and cause is osteoporosis. Osteoporosis is a medical diagnosis where bones become brittle over time. It is most common in both sexes after 60 yrs of age, and women after menopause. Injury and disease are other causes for VCF. There are jobs that require heavy lifting that put people at risk for VCF. Injuries also occur while playing sports, car accidents, or from falls.
Having a low bone mineral density can increase risk of VCF. This can be caused by not getting enough calcium or enough exercise with weight bearing involved (including walking and jogging). Weight loss and having a low body weight can also lead to VCF. Smoking and excessive alcohol consumption also increase the risk of VCF.
What are the Symptoms of VCF?
Mild versions of VCF will not display any symptoms at all, such as from a minor fall. Other times, there may be back spasms, pain to the touch, problems with urination or defecation, severe back pain, or sudden weakness in the arms and legs. If any of these symptoms are present, it’s best to get treatment from Pain Management Doctorsimmediately.
What are the Preferred Treatments?
There are several non-surgical treatments for VCF. Over-the-counter pain medicines are considered first and pain management doctors can prescribe medicines to treat the pain. Pain relief is usually the first concern of most patients, as VCF can be extremely painful. It used to be that a back brace was considered the best treatment, but new research has shown that this can lead to too much pressure on the outside of the spine and may even worsen the condition. Back braces can weaken muscles that are needed for recovery and to prevent re-injury.
If pain treatments are not effective within a month, then surgery is the next option for treatment. There are two main types of surgeries, and a third new surgery that is being used more often. These surgeries are called vertebroplasty, kyphoplasty, and RF-Targeted Vertebral Augmentation (or RF-TVA).
A vertebroplasty can reduce or eradicate the pain by injecting liquid bone cement into the collapsed vertebrae. This keeps the fracture from moving around and is designed to relieve pain in this way. It is the same idea as using a cast to hold a limb fracture in place. A kyphoplasty is similar to a vertebroplasty, except a balloon-like device is inserted before the liquid bone cement is injected to inflate and set the fracture. RF-TVA is the third surgical option, and is also designed to reduce invasiveness as opposed to other options. RF-TVA generally takes under and hour and requires only an incision large enough to be covered by a band-aid.
Other treatments and follow-ups include physical therapy and targeted exercise programs. Physical therapy will often offer the patient exercises that help reverse the damage done by immobility. Exercises may include weight-bearing exercises, including pilates and Tai Chi. Abdominal exercises are often encouraged as well, but not crunches and sit ups, as those can cause more harm than good.
If the fracture is caused by osteoporosis, weight-bearing exercises will be prescribed along with calcium, vitamin D, and even hormone replacement therapy (except in the case of those with a history of breast cancer).