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Vertebral Fracture by Editorial Staff and Contributors

En Español (Spanish Version)

Definition

The bones of the back are called the vertebrae. A vertebral fracture is a break in one of these bones.

Vertebral Fracture

Causes

A vertebral fracture can be caused by:

Osteoporosis —a condition of weakened bones
Getting a blow to the back
Falling down
Landing on your heels when jumping from a height
Having major trauma as from a motor vehicle accident

Risk Factors

Other than trauma, osteoporosis is the main cause of most vertebral fractures.

Factors that increase the risk of osteoporosis include the following:

Race: Caucasian or Asian
Sex: female
Advancing age:
- Females: 60 and older
- Males: 70 and older
Postmenopausal
Stroke
Hyperthyroidism
Use of certain medications
- Long-acting benzodiazepines
- Tricyclic antidepressants
- Anticonvulsants
- Long-term steroid use
Limited physical activity
Housebound
Poor nutrition
Smoking
Mother or maternal grandmother with hip fracture (a genetic disposition)
Other factors that may increase the risk of vertebral fractures include the following:
- Use of antipsychotic medications
- Poor mental functioning
- Poor mobility
- Poor strength
- Previous vertebral fracture within the last year

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. A physical exam will be done.

Test may include:

X-rays —of your spine to look for a fracture
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. Liquid cement is injected into the vertebra. It can help relieve the pain associated with vertebral fractures. This is not a common operation. It is not suitable for everyone. Talk with your doctor to see if this option may be right for you.

Nonsurgical Treatments

Your doctor may prescribe:

Brief period of bed rest and a decrease in activity
Medication to control the pain
Strengthening exercises for your back muscles
Back brace

Treatment for Osteoporosis

Medications

To prevent further bone loss, medications may include:

Estrogen/progesterin hormone replacement therapy
Bisphosphonates ( Fosamax , Actonel , Boniva )
Selective estrogen receptor modulators ( Evista )
Calcitonin (Miacalcin, Fortical)

If osteoporosis is the cause of your fracture, your doctor may prescribe the following:

Vitamin and mineral supplements, especially calcium and vitamin D —Studies indicate that the combination of calcium and vitamin D appear to help bone loss
Lifestyle changes to help maintain your bones—may include weight-bearing and resistance exercises for both the upper and lower extremities

If you are diagnosed with a vertebral fracture, follow your doctor's instructions .

Prevention

Building strong bones will help prevent 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.

Get plenty of weight-bearing exercise. This includes walking, jogging, or certain sports such as tennis.
Do resistance exercises for arms and legs. This will help to improve your strength and balance.
Get plenty of calcium, vitamin D, and protein in your diet. Talk to your doctor if you think you need supplements .
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.
Stop smoking. Drink alcohol only in moderation. Moderate alcohol intake is two drinks per day for men and one drink per day for women.
Eliminate any obstacles in your house which could cause you to fall. This may include throw rugs or furniture.

RESOURCES:

National Institutes of Arthritis and Musculoskeletal and Skin Diseases http://www.niams.nih.gov/default.asp
National Osteoporosis Foundation http://www.nof.org/index.htm

CANADIAN RESOURCES:

Canadian Orthopaedic Association http://www.coa-aco.org/
Women's Health Matters http://www.womenshealthmatters.ca/

References:

American Medical Association website. Available at: http://www.ama-assn.org/ . Accessed July 8, 2009.
Bone resource page. National Institutes of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health_Info/Bone/default.asp . Updated November 2007. Accessed July 8, 2009.
Osteoporosis. American College of Obstetricians and Gynecologists Practice Bulletin. No. 50; 2004.
Ullom-Minnich P. Prevention of osteoporosis and fractures. Am Fam Physician . 1999;60(1):194-202.

Last reviewed November 2009 by Robert E. Leach, MD

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