Osteoporotic Compression Fractures and Vertebroplasty

Osteoporosis increases the risk of fractures. This can happen following a fall for example but can also involve the bones in the spine, known as the vertebrae, even in the absence of any injury. These osteoporotic compression fractures (also known as wedge fractures) are very common in the older osteoporotic population. Assessment of bone mineral density (with DEXA) allows identification and treatment of osteoporosis and aims to reduce the risk of such fractures. Significant pain relief is expected in over 85% of cases. Stabilisation and pain control helps preserve mobility and function.

Osteoporotic Compression Fracture Symptoms

Spinal fractures from osteoporosis usually cause sudden severe pain in the back which can spread around the sides and the front of the chest or abdomen. This pain can be difficult to control even with very strong painkillers.

What causes osteoporotic compression fractures?

Osteoporosis is most often due to vitamin D deficiency but can be due to more complicated medical conditions such as liver or kidney disease. Compression fractures can also occur in the context of cancer spread to the spine but these can usually be distinguished on an MRI or CT scan.

How is a compression fracture diagnosed?

Whilst compression fractures are usually seen on x rays, they are more accurately assessed on a CT or MRI scan. If treatment, such as vertebroplasty, is planned then CT is essential in establishing suitability. If the age of the fracture is unclear then MRI is very helpful in checking whether the fracture is recent or older.

Do I need treatment?

No. Treatment is indicated if pain is not controlled well. In some cases, there is also a good reason to avoid the use of opiate painkillers and so treatment is indicated. If pain is minimal and well controlled then treatment may not be required.

How is a compression fracture managed?

If osteoporotic then you will have to have your bone mineral density assessed. A trial of painkillers is started. If there is inadequate improvement you may be referred for vertebroplasty.

When you are seen by the IR specialist you can trust that you will be only offered treatment if it is thought to be your best option.