A vertebral fracture is a break in one of the bones of the spine. These bones are called the vertebrae.
Causes
A vertebral fracture can be caused by:
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition. The main risk factors for a vertebral fracture are factors that increase the risk of osteoporosis—the main cause of most vertebral fractures other than major trauma. Factors that increase the risk of osteoporosis include the following:
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Race: White or Asian
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Sex: Female
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Advancing age:
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Being postmenopausal
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Stroke
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Hyperthyroidism
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Use of certain medications
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Limited physical activity
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Being housebound
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Poor nutrition
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Smoking
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Mother or maternal grandmother with hip fracture
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Other factors that may increase the risk of vertebral fractures include the following:
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Symptoms
Symptoms may include mild to severe pain in the middle or lower back.
Diagnosis
The doctor will ask about your symptoms and medical history, and perform a physical exam.
Test may include:
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X-rays of your spine to look for a fracture
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Bone mineral density test to help determine if you have osteoporosis, and if so, how severe it is
Treatment
Treatment includes:
Surgery
Vertebroplasty is a relatively new procedure that involves injecting liquid cement into the backbone. It can help relieve the pain associated with vertebral fractures. However, this is not a common operation and not suitable for everyone. Talk with your doctor to see if this treatment option may be right for you.
Non-surgical Treatments
Your doctor may prescribe:
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Brief period of bed rest and a decrease in activity
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Medication to control the pain
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Strengthening exercises for your back muscles
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Back brace
Treatment for Osteoporosis
If osteoporosis is the cause of your fracture, your doctor may prescribe the following:
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Medications for pain–consult with your doctor as to which type of medication is best for you
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Medications to prevent further bone loss which would include: estrogen/progestin hormone replacement therapy, bisphosponates (Fosamax, Actonel, Boniva), selective estrogen receptor modulators or SERMs (Evista), and calcitonin
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Vitamin and mineral supplements, especially calcium and vitamin D
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Lifestyle changes to help maintain your bones, such as weight-bearing exercise and resistance exercises for both the upper and lower extremities
Prevention
Building strong bones will help prevent vertebral fractures. However, most bone strength is attained by women before they are age 25. That makes maintaining bone density and strength at older ages even more important.
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Get plenty of weight-bearing exercise such as walking, jogging, or certain sports such as tennis.
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Do resistance exercises for arms and legs to improve your strength and balance.
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Get plenty of calcium, vitamin D, and protein in your diet. Talk to your doctor if you think you need supplements.
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If you have osteoporosis you should talk to your doctor about treatment options. If you had an early menopause talk to your doctor about this.
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Stop smoking and drink alcohol only in moderation. Moderate alcohol intake is two drinks per day for men and one drink per day for women.
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Eliminate any obstacles in your house, such as throw rugs or furniture, which could cause you to fall.
RESOURCES:
National Osteoporosis Foundation
http://www.nof.org
Osteoporosis and Related Bone Diseases, National Resource Center, National Institutes of Health
http://www.osteo.org
References:
American Medical Association website. Available at: http://www.ama-assn.org/.
Osteoporosis. ACOG Practice Bulletin No. 50. 2004 Jun.
Osteoporosis and Related Bone Diseases, National Resource Center, National Institutes of Health website. Available at: http://www.osteo.org.
Prevention of Osteoporosis and Fractures. Am Fam Physician. 1999 Jul.
