• London Spinal Partnership

What is a vertebral compression fracture?

Mr David Bell explains what a vertebral compression fracture is, who might get it and how they are treated.

Vertebral compression fractures occur when the vertebra (spine bones), that weigh bear, become compressed or squashed. This is most common in the lower spine (lumbar), however, can still occur in any part of the spine.

How do people get vertebral compression fractures?

A vertebral compression fracture can be caused by three possible factors:

Osteoporotic: Osteoporosis is a disease of the bone which causes reduced bone density. This can increase the chance of a vertebral compression fracture without trauma. The risk of osteoporosis and therefore vertebral compression fractures affect women post-menopausal.

Trauma: A vertebral compression fracture is usually caused by a high impact incident. This can be as a result of a fall, landing feet first or road traffic accidents.

Pathological: Pre-existing disease may be the cause of the fractures, such as metastatic cancer, along with other conditions such as osteomyelitis (infection of the bone) or Paget’s disease.

Signs you might have a vertebral compression fracture

There are a number of different symptoms that can be linked to a vertebral compression fracture, this includes

  • Pain – especially in the lower back.

  • Numbness, tingling and weakness – this can occur if the bony fragments from the fracture cause compression of the nerves at the fracture level.

  • Incontinence or urinary retention – this can occur if fracture fragments press on the spinal cord.

By looking at images of the spine using aids such as an X-ray, CT or MRI scans, you can see any abnormalities and therefore diagnose a vertebral compression fracture.

How to treat vertebral compression fractures

There are a number of different treatment options that can be used to treat a vertebral compression fracture.

  • Back brace

  • Rest and ice

  • Pain relief – including non-steroidal anti-inflammatories, muscle relaxants

  • Exercise – when signed off by the doctor to prevent further osteoporosis and strengthen the muscles in the back.

If conservative methods of treatment are not successful, then surgery may be the next option.

Kyphoplasty: This is a minimally invasive procedure that has the aims to reduce or stop the pain caused by micro-movement (small movement) in vertebrae which can result in a bone fracture. During kyphoplasty, the spine is accessed from the back via a small keyhole incision, this incision is used to pass a narrow tube through, all of which is guided by an X-ray. The surgeon inserts a special balloon through the tube into the vertebra and gently adds air to inflate it. As the balloon inflates it compacts the soft bone to create a void inside the vertebra, which will help to keep it stable. It can also help to partially restore the height of the vertebral body. The balloon is then removed and a cement-like material is injected into the void, which quickly hardens to stabilise the bone.

Vertebroplasty: This is also a minimally invasive procedure which aims to reduce or stop the pain caused by micro-movement in vertebrae which can often result in a bone fracture. During a vertebroplasty the spine is accessed from the back via a small keyhole incision, a tube is then passed through this incision, which is guided by an X-ray to ensure that it reaches the exact location. The tube creates a pathway from the skin to the damaged vertebral body. The surgeon injects a cement-like material into the vertebra body via the tube. The cement-like material (polymethylmethacrylate) hardens quickly once injected to stabilise the bone, allowing the bone to stay still while it repairs.

Decompression: This is performed to relieve the pressure on the spinal cord, during this procedure part of the bone is removed from the back of the spine.

How can a vertebral compression fracture be prevented?

Most cases of vertebral compression fractures are caused as a result of osteoporosis, therefore by reducing the risk of osteoporosis, you will also reduce the risk of a fracture. So, here’s how you can do that

  1. A balanced diet with plenty of Calcium and vitamin D

  2. Exercise particularly weight-bearing exercise to help keep bone strength high

  3. Quit smoking

This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.


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