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Vertebral Fracture
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Vertebral Fracture

(Spinal Fracture)

En Español (Spanish Version)

Definition

A vertebral fracture is a break in one of the bones of the spine. These bones are called the vertebrae.

Vertebral Fracture

factsheet image

© 2008 Nucleus Medical Art, Inc.

Causes

A vertebral fracture can be caused by:

  • Having osteoporosis—This is a condition in which there is too little bone, which causes the vertebra to be weakened.
  • 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

A risk factor is something that increases your chance of getting a disease or condition. 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, and perform a physical exam.

Test may include:

Treatment

Treatment includes:

Surgery

Vertebroplasty is a relatively new procedure that involves injecting liquid cement into the vertebra. 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.

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

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

  • Medications for pain—Consult with your doctor as to which type of medication is best for you.
  • Medications to prevent further bone loss—These may include: estrogen/progesterin hormone replacement therapy, bisphosphonates (Fosamax, Actonel, Boniva), selective estrogen receptor modulators (Evista), and calcitonin.
  • Vitamin and mineral supplements, especially calcium and vitamin D—Studies indicate that vitamin D is very important. The combination of calcium and vitamin D appears to help bone loss.
  • Lifestyle changes to help maintain your bones—These may include weight-bearing 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.

  • Get plenty of weight-bearing exercise such as walking, jogging, or certain sports such as tennis.
  • Do resistance exercises for arms and legs 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, 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

CANADIAN RESOURCES:

Canadian Orthopaedic Association
http://www.coa-aco.org/

Women's Health Matters
http://www.womenshealthmatters.ca/index.cfm

References:

American Medical Association website. Available at: http://www.ama-assn.org/ .

Osteoporosis. American College of Obstetricians and Gynecologists Practice Bulletin. No. 50. 2004 June.

Osteoporosis and Related Bone Diseases website. Available at: http://www.osteo.org .

Prevention of osteoporosis and fractures. Am Fam Physician . 1999 July.



Last reviewed March 2008 by Robert E. Leach, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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