Vertebral Body and Spinal Compression Fractures

Vertebra or spinal bone
Vertebra or spinal bone. MedicalRF.com/Getty Images

Getting old isn't easy, especially when you've been diagnosed with osteoporosis or osteopenia. These related disorders, which are characterized by thinning and weakened bones, often lead to vertebral compression fractures — or more simply put, bone breaks in spinal vertebrae.

In fact, osteoporosis causes one fracture, of any type, every 3 seconds, according to the International Osteoporosis Foundation.

Vertebral compression fractures generally occur when the vertebral body, which is front part of the spinal bone, cannot support the load of the spine from above.

A meta-analysis protocol, published in 2017, reports that vertebral fractures tend to occur following a collapse of the front of the spinal column. 

Symptoms and Causes of Vertebral Compression Fractures

While age-related osteoporosis or osteopenia are the main causes of spinal fracture, there are other causes as well. These may include injury to the spine, or diseases that compromise bone. Cancer and infection are two examples of diseases that sometimes lead to compression fractures.

Symptoms of a spinal compression fracture include severe, acute back pain that gets better when you rest. The area near the injury may be tender to the touch, as well.

And pain related to spinal fracture may occur when you bend or twist your spine.

Although rare in cases of spinal fracture, you might also experience radiculopathy, or nerve related sensations — plus pain, of course — that go down one leg or arm.

Along with back pain — whether a short term flare up or chronic — a vertebral fracture may result in spinal deformity and/or affect your physical functioning. Disability, decreased ability to carry out daily activities, diminished quality of life and higher medical costs are common.

Are You at Risk for a Spinal Vertebral Fracture?

Senior and elderly women are those most affected osteoporosis or osteopenia related spinal fracture.

A 2012 study published by the Permanente Journal found that about 25% of all postmenopausal women experience a spinal fracture some time during their lives. 

If you're a woman over the age of 50 and you live with either disease, you have an approximately one in three chance of sustaining a spinal fracture, according to the International Foundation of Osteoporosis. And once you've had one fracture you're more likely to sustain more, they say.

Understand the Vertebral Body

As mentioned above, spinal compression fractures mainly affect the vertebral body. The vertebral body is the largest part of the spinal bone, and it comprises the anterior portion of the vertebra, meaning it is located in front, relative to the bony ring that attaches in the back. 

From a side view, the anterior portion of the vertebral body is closer to the front of your body, while the bony ring is closer to the back.

The vertebral body is generally shaped like a short cylinder. In normal, uninjured spinal bones, this cylindrical shape varies a bit, depending upon whether it's located in the cervical, which corresponds to the neck, thoracic, corresponding to the mid and/or upper back, or lumbar, aka, low back, areas of the spine. (The same is also true of the other parts of the vertebra; for example, the spinous processes on the back of cervical vertebrae are more elongated than those of the lumbar spine.)

The vertebral bodies in the lumbar spine are thicker, stronger and built more upright than are the thoracic and cervical vertebrae. This is likely related to the extra weight bearing required of lumbar vertebrae as compared to the thoracic and cervical, which are located above them. 

The vertebral bodies of the spine stack up on one another to create the vertebral column. The vertebral bodies help provide important support for sitting, standing, walking and other movements. Between the vertebral bodies are the intervertebral discs, which provide cushioning and shock absorption.

The vertebral bodies combine with other areas of the bone to provide the boundaries for the spaces through which the spinal cord travels, as well as branching nerves that exit the spine on their way out to enervate all parts of the body.

Treatments for Vertebral Compression Fractures

Treatmens for broken spinal bones include surgery and conservative care.

Conservative, aka non-surgical care, may consist of bed rest, medication, wearing a back brace and/or physical therapy. If you go the conservative route, know that strengthening your spine will be an important part of your therapy.

As compression fractures generally result in a loss of height of the vertebral body, restoring that height is the goal of surgical treatment.

The loss of height is may cause the vertebral body to erode into a wedge shape. The bony ring that is attached to the back of the vertebral body remains largely unphased.

The two most commonly given surgeries are balloon kyphoplasty and percutaneous vertebroplasty. Both procedures attempt to restore lost height to the collapsed bone. If you decide on a balloon kyphoplasty, deciding and moving on it early may serve you best. A 2018 study published in the journal Clinical Neurology and Neurosurgery found that while this technique is helpful for avoiding future collapses, patients who have the procedure within four weeks of the injury get more back pain relief, better alignment of the repaired bone, and fewer subsequent fractures.

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