A lumbar compression fracture involves the lumbar vertebrae and occurs typically secondary to bone demineralization. It is seen in postmenopausal women and in the elderly due to osteoporosis but may also be associated with malignancies. Therefore a thorough workup is essential to detect the fracture and its cause.
Although compression fractures can occur anywhere along the vertebral column, they are most common at the thoracolumbar junction involving the T8-T12, L1, and L4 vertebrae . The incidence of this condition increases steadily with advancing age . Lumbar compression fractures can be asymptomatic and may be detected incidentally in the elderly on lumbar X-rays or may present insidiously with a backache. The pain is typically in the midline, aching or stabbing in quality, non-radiating and severe enough to cause disability and interfere with activities of daily living. The pain is usually relieved by lying supine and is aggravated by standing or walking. The pain often persists even after the fracture has healed . However young adults with lumbar compression fractures may be diagnosed with a severe back pain of sudden onset and neurologic deficits in the lower limbs following a vehicular accident. The incidence of associated radiculopathy increases with descending spinal levels . In the elderly, multiple fractures over a period of time lead to decrease in height and stature with subsequent paraspinal muscle shortening, lumbar lordosis, and thoracic kyphosis. As a result, the individual has to actively contract the paraspinal muscles to maintain posture leading to fatigue and in severe cases, it can lead to impaired lung function, abdominal protuberance, compression of abdominal organs with early satiety and loss of weight .
Individuals with lumbar compression fractures secondary to malignancies like multiple myeloma or metastasis may present with fever of unknown origin, night sweats, anorexia, weight loss or a history of a previous breast or prostate malignancy.
Entire Body System
METHODS: An 83-year-old male presented with low back pain two years after sustaining osteoporotic compression fracture at L3 due to a fall. [ncbi.nlm.nih.gov]
Jumps or falls from heights cause burst fractures. These fractures can also result in serious neurological injury. [emedicine.medscape.com]
Case Study: Explanation: A 66-year-old man presents with severe lower back pain after falling from an 8-foot ladder one week previously. [clinicaladvisor.com]
Occasionally, compression or other vertebral fractures result from significant force (eg, a motor vehicle crash, a fall from a height, a gunshot wound). [merckmanuals.com]
Numbness, tingling, and weakness: Such symptoms could mean compression of the nerves at the fracture site. [emedicinehealth.com]
Numbness or weakness. If the nerves around the injury are affected, there can be numbness, tingling or weakness in the back or legs. Urination or bowel issues. [rosenfeldinjurylawyers.com]
Osteoporosis is a condition that causes your bones to become weak and brittle. People with weak bones can get fractures by bending forward, standing from a seated position, sneezing, or strong coughing. [drugs.com]
The jurors clearly did not believe that she had no prior pain or disabilities nor were they impressed with the severity of the "new" or increased injuries given the lack of significant treatment. [newyorkinjurycasesblog.com]
Pain can be disabling, and take weeks to months to go away. Compression fractures due to osteoporosis may cause no symptoms at first. Often, they are discovered when x-rays of the spine are done for other reasons. [medlineplus.gov]
Assessment of Quality of Life (AQoL) questionnaire EQ–5D Roland–Morris Disability Questionnaire. [physio-pedia.com]
- Surgical Procedure
Both of these procedures have a very low risk of complication, typically less then 1-2 percent Though no surgical procedure is guaranteed to help 100 percent of patients, these two procedures dramatically reduce pain in the vast majority of appropriately [medcenterblog.uvmhealth.org]
Surgical Treatment Vertebroplasty and kyphoplasty are minimally invasive surgical procedures performed to treat vertebral compression fractures. Sometimes, treatment involves spinal instrumentation and fusion. [coloradospineinstitute.com]
What procedures are there for fractured vertebrae? Vertebral fractures have always been more difficult to treat than other fractures, such as hip or wrist fractures which can be treated surgically. [cirse.org]
Vertebral compression fracture treatments The following minimally invasive surgical procedures are performed for vertebral compression fracture: Vertebral body augmentation [lamisinstitute.com]
The most common surgical procedures for spinal compression fractures are lumbar fusion and vertebroplasty/kyphoplasty. In a lumbar fusion, the vertebrae are connected with rods. [weillcornellbrainandspine.org]
INTRODUCTION: Vertebral hemangiomas are benign vascular tumours of the bony spine which are usually asymptomatic. Pregnancy-related anatomical and hormonal changes may lead to expansion of hemangiomas and development of neurological symptoms. [ncbi.nlm.nih.gov]
Most vertebral compression fractures are a consequence of osteoporosis, are asymptomatic or minimally symptomatic, and occur with no or minimal trauma. [merckmanuals.com]
Lumbar compression fractures can be asymptomatic and may be detected incidentally in the elderly on lumbar X-rays or may present insidiously with a backache. [symptoma.com]
Our patient, after jejunostomy creation and starting of enteral nutrition, was asymptomatic, and so, in April 2016, hormone therapy with fulvestrant was started (500 mg, day 0, 14, and 28 and every 28 days thereafter by intramuscular injection). [hindawi.com]
You cough up blood. Your arm or leg feels warm, tender, and painful. It may look swollen and red. You have new problems urinating or having bowel movements. [drugs.com]
Sometimes, however, when osteoporosis is really advanced, fractures can occur with relative ease and could be caused by the slightest movement, like turning over in bed or perhaps coughing. [dynamicdiscdesigns.com]
There may be no preceding trauma or only minimal trauma (eg, a minor fall, sudden bending, lifting, coughing). Patients who have had an osteoporotic vertebral fracture are at higher risk of other vertebral and nonvertebral fractures. [merckmanuals.com]
Management: Stable Compression Fractures Confirm that Fracture site is stable (typical) Symptomatic back pain management (includes Opioids) Should allow for adequate lung excursion with prevention of Atelectasis and secondary Pneumonia Initial excessive [fpnotebook.com]
With a minimally invasive approach, patients are less likely to experience dangerous symptoms caused by inactivity—like pneumonia. [youtube.com]
This is because too much rest can lower bone mineral density, weaken muscles, cause bed sores, and it may even increase your risk of pneumonia and urinary tract infections. [spineuniverse.com]
Complications associated with fractures of the thoracic and lumbar spine include: Blood clots in the pelvis and legs—these may develop during long periods of bed rest or immobility Pulmonary embolism—a blood clot that breaks free and travels to the lungs Pneumonia [orthoinfo.aaos.org]
Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation. Bisphosphonates and calcitonin may be recommended to help your bones get stronger. [drugs.com]
This symptom can be caused by the shorter spine putting pressure on the stomach leading to stomach and digestive issues such as loss of appetite, constipation and weight loss. [apmhealth.com]
Crowding of internal organs Respiratory decrease-atelectasis, pneumonia Prolonged pain Low self-esteem Emotional and social problems Increased nursing home admissions Mortality TABLE 1 Complications from Compression Fractures of the Spine Constipation [aafp.org]
These fractures can result in other complications, however, such as: Reduced spinal range-of-motion Lung disorders, such pneumonia or a collapsed lung Crowding of internal organs Constipation Bowel obstruction Progressive muscle weakness Deep venous thrombosis [paindoctor.com]
[…] is needed to avoid problems with kidneys and stomach Should not be taken for long periods if possible Opiates (medications related to morphine) These are very strong painkillers Available only on prescription Can cause drowsiness, confusion, falls, constipation [bsir.org]
World J Surg Oncol 2017 ; 15 : 123. 2 Just scratching the surface: intractable nausea and vomiting. Am J Med 2015 ; 128 : e3 – 5. 3, et al. Scirrhous gastric carcinoma: endoscopy versus upper gastrointestinal radiography. [academic.oup.com]
Signs and symptoms are nonspecific: satiety, nausea and vomiting, epigastric pain, and weight loss. Patients may present progressive dysphagia. [orpha.net]
Patients with gastric cancer will present with abdominal pain and weight loss more than 50% of the time.2 Additional symptoms include nausea, dysphagia, gastrointestinal bleeding (hematemesis, melena), and early satiety. [cancertherapyadvisor.com]
Some of the most common symptoms of advanced stomach cancer are: nausea and vomiting frequent heartburn loss of appetite, sometimes accompanied by sudden weight loss constant bloating early satiety (feeling full after eating only a small amount) bloody [healthline.com]
She presented with upper abdominal pain, dyspepsia, nausea, and daily postprandial vomiting with weight loss of approximately 4 kilograms in 2 months. The Eastern Cooperative Oncology Group (ECOG) performance status (PS) was 2. [hindawi.com]
The excess hormone secretion of carcinoid tumors may lead to a condition called carcinoid syndrome, marked by flushing, abdominal pain, diarrhea, constriction of the bronchial tubes in the lungs and, in some cases, heart troubles like valve dysfunction [cancercenter.com]
- Back Pain
We present an unusual case of vertebral fracture due to an undiagnosed hemangioma presenting as postpartum back pain following epidural analgesia. [ncbi.nlm.nih.gov]
It is by this mechanism that abdominal binders provide spinal support and hence relieve back pain. [oandplibrary.org]
Here is what the vertebrae look like when affected by osteoporosis (porous bones): Plaintiff, of course, urged that since she never before had any back pain, or any treatment related to her back, all of her current complaints of pain and disability had [newyorkinjurycasesblog.com]
There are many causes of back pain and as our population ages, degenerative diseases of the spine and osteoporosis will result in an increase in episodes of back pain in the U.S. population. [medcenterblog.uvmhealth.org]
- Low Back Pain
METHODS: An 83-year-old male presented with low back pain two years after sustaining osteoporotic compression fracture at L3 due to a fall. [ncbi.nlm.nih.gov]
The majority of low back pain (LBP) is perceived to originate from the lumbar spine; however, another likely source of LBP that is mostly overlooked is the SIJ. [pubfacts.com]
CONTINUE SCROLLING OR CLICK HERE FOR RELATED SLIDESHOW QUESTION Nearly everyone has low back pain at some time during their life. See Answer [medicinenet.com]
Therefore, a compression fracture should be suspected in any patient older than 50 years with sudden onset of mid- or low-back pain. [uclahealth.org]
- Muscle Strain
strain or other soft tissue injury, or as a common part of aging. [spine-health.com]
Injuries can range from relatively mild ligament and muscle strains, to fractures and dislocations of the bony vertebrae, to debilitating spinal cord damage. [mayfieldclinic.com]
Injuries can affect the bone (fractures), the disks (herniations), ligaments (sprain), or muscles (strain). Each of these tissues has different needs while healing and some take longer than others. Doctors will list the level or levels affected. [understandspinesurgery.com]
- Spine Pain
If fractures occur in the lower spine, wearing a brace is sometimes recommended to relieve pain and make walking less painful. How effective bracing is unclear. Sometimes bed rest is needed for a few days. [merckmanuals.com]
Case presentation A 49 year-old Caucasian male presented with progressively worsening pain in the thoracic spine for 10 days and painful bilateral lower extremity edema. [casesjournal.biomedcentral.com]
Generally, VCFs are more commonly associated with localized spinal pain than with neurologic complaints; however, lower lumbar fractures, especially at L5, have a significant incidence of presenting with radiculopathy. [cureus.com]
The incidence of associated radiculopathy increases with descending spinal levels. [symptoma.com]
Injury to a single nerve (sciatica or radiculopathy) may be intensely painful, but is less likely to cause major, permanent problems. [understandspinesurgery.com]
When nerve pain is involved, antidepressants and anti-seizure medications are helpful in decreasing the shooting, tingling pain in the extremities. [completepaincare.com]
- Urinary Retention
Symptoms of a spine injury in the thoracic, lumbar and sacral regions can include: Neck or back pain, especially when moved Tenderness Numbness Tingling or a pricking sensation of the skin Paralysis Urinary or fecal incontinence Urinary retention To diagnose [chop.edu]
However, narcotics have significant side effects, including reduced gastrointestinal motility, urinary retention, reduced respiratory drive and cognitive deficits, with loss of balance, increase of falls and depression. 64 In addition, muscle relaxants [bmb.oxfordjournals.org]
- Flank Pain
Severe kyphosis is associated with reduction in the space between the lower ribs and the iliac crest, flank pain and compromission of breathing. 121 Back extensor exercises improve back strength, providing a better dynamic-static posturing and reducing [bmb.oxfordjournals.org]
- Renal Insufficiency
Because traditional NSAIDs are related to the risk of gastrointestinal bleeding and renal insufficiency, agents such as COX2 inhibitors could be considered. 62 A recent meta-analysis of case–control and cohort studies assessed the impairment of bone healing [bmb.oxfordjournals.org]
Lumbar compression fracture should be suspected in postmenopausal women and the elderly who present with sudden onset severe lumbar pain. Many patients may remember a specific injury  although the condition may present without any prior history of trauma. Tenderness is typically elicited on palpating directly over the fracture site and there may also be kyphosis . A thorough neurological examination is necessary but may not reveal any deficits in uncomplicated fractures.
Plain X-rays of the spine will confirm the diagnosis and reveal the classic wedge deformity corresponding to the site of maximum tenderness. A reduction in vertebral height by 20% or a decrease of at least 4 mm compared to the baseline height is an indication of a compression fracture . Ideally, the entire spine should be imaged to exclude multiple fractures and occasionally serial imaging may be required to detect the fracture.
Techniques like computed tomography (CT), magnetic resonance imaging (MRI) help in diagnosis by excluding the other etiologies of back pain. They also confirm the integrity of the posterior vertebral wall . In addition, a CT can detect a compression fracture (not visualized on plain radiographs), spinal canal narrowing and differentiate between a compression fracture and a burst fracture. An MRI is indicated in patients with neurologic deficits, or if a malignancy is suspected as the underlying cause of the lumbar compression fracture. Positron emission tomography (PET) can also be ordered to differentiate between compression fractures of benign versus malignant etiology.
Laboratory tests like erythrocyte sedimentation rate, complete blood count (CBC), prostate-specific antigen testing, serum protein electrophoresis to exclude multiple myeloma and urinalysis for Bence-Jones proteins should be routinely performed. Bone density scanning is recommended to measure the severity of osteoporosis and for further patient management .
Review of the literature]. 38 Soulie M...Pontonnier F 8401630 1993 49 Linitis plastica carcinoma of the colon mimicking Crohn's colitis. 38 Cox MR...Smart P 1642587 1992 50 Urogenital linitis plastica metastatic from stomach. 38 Leddy FF...Ning TC 1580041 [malacards.org]
Published on May 9, 2017 Deuk Spine Institute, Injury Treatment Group, Surgery Center of Viera. [youtube.com]
This was an 81 year old woman with very little treatment and a pre-existing condition directly related to the injuries claimed at trial. [newyorkinjurycasesblog.com]
What treatment options are available? Because compression fractures most often heal on their own with time, treatment is usually conservative. [summitortho.com]
The treatment plan depends on the age and type of compression fracture present. Our Pain Medicine physicians have a wealth of treatments in their arsenal to treat compression fractures. [completepaincare.com]
Initial treatment was focused on providing adequate pain control. [ncbi.nlm.nih.gov]
Prognosis Gastric LP has a very poor prognosis due to the frequent occurrence of peritoneal dissemination, lymphatic invasion and extension toward neighboring organs. The 5-year survival rate is around 10-20% in Japan and Europe. [orpha.net]
Low-impact aerobic exercise like walking may be suggested by your physical therapist, but will depend on your progress and prognosis following injury or pain as well as what caused the compression fracture in the first place. [livestrong.com]
Treatment and prognosis Management options include: non-surgical observation/bracing medications: bisphosphonates for osteoporosis surgical vertebroplasty [radiopaedia.org]
While the diagnosis can be suspected from history and physical examination, plain x-rays, as well as a CT scan or MRI, are often helpful in accurate diagnosis and prognosis. [uclahealth.org]
Positron emission tomography (PET) can also be ordered to differentiate between compression fractures of benign versus malignant etiology. [symptoma.com]
Etiology LP is generally a sporadic disease but familial cases have been described. Etiology is unknown. [orpha.net]
[…] fracture of unspecified lumbar vertebra, initial encounter for open fracture see all Compression fracture ICDF-10 coding Compression Fractrue ICD-9 805.4 (Fracture of vertebral column without spinal cord injury (lumbar, closed) Compression Fractrue Etiology [eorif.com]
Often the patient will prefer to stand - reducing the axial load on the spine - instead of sitting.1 If the patient is older than age 40, it is important to rule out pathologic weakening of the bone as an underlying etiology to the compression deformity [dynamicchiropractic.com]
Epidemiology of Vertebral Fractures. J Clin Densitom. Jan-Mar 2016;19(1):8-22. Kevin Phan, Prashanth J Rao, Ralph J Mobbs. [danielebarnabei.it]
1995, 17(5 Suppl): p. 505S-511S. 3.Melton L.J. 3rd., "Epidemiology of spinal osteoporosis," Spine, 1997;22:2S-11S. 4." [spine-health.com]
[…] of unspecified lumbar vertebra, initial encounter for open fracture see all Compression fracture ICDF-10 coding Compression Fractrue ICD-9 805.4 (Fracture of vertebral column without spinal cord injury (lumbar, closed) Compression Fractrue Etiology / Epidemiology [eorif.com]
Summary Epidemiology Gastric LP accounts for about 10% of all gastric cancers but the exact prevalence in the general population is unknown. [orpha.net]
These worries are not unfounded, because there is a substantial risk of subsequent fractures of all types and further morbidity in persons who have had a vertebral compression fracture. 9 Pathophysiology and Risk Factors Vertebral compression fractures [aafp.org]
Taking steps to prevent and treat osteoporosis is the most effective way to prevent compression or insufficiency fractures. Getting regular load-bearing exercise (such as walking) can help you avoid bone loss. [medlineplus.gov]
Doing so helps prevent loss of muscle tone and additional loss of bone density. People with osteoporosis are treated with bisphosphonates and sometimes calcitonin. Both drugs help prevent bone from breaking down and increase bone density. [merckmanuals.com]
Preventing osteoporosis, or treating it if you have it, is the best way to help prevent compression fractures. [cedars-sinai.org]
In several, small patient studies, preventive vertebroplasty for the adjacent vertebrae above and below combined with vertebroplasty for the acutely fractured vertebra was effective in the prevention and cascading of untreated adjacent fractures. [cureus.com]
This is more serious and may require immediate treatment to prevent or relieve pressure on the spinal cord or nerves. [orthopedics.about.com]
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