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Vertebral Compression Fracture

Presentation

Herein, we present 3 new cases of AL amyloidosis with spontaneous vertebral compression fracture and review 13 cases retrieved from the literature. [ncbi.nlm.nih.gov]

In such cases, a spinal cord injury is often also present, and the spine may be fractured in > 1 place. [merckmanuals.com]

Hematological

  • Prolonged Bleeding

    Contraindications include systemic pathologies such as sepsis, prolonged bleeding times or cardiopulmonary conditions that would preclude the safe completion of the procedures. [healio.com]

Entire Body System

  • Severe Pain

    Surgery is normally reserved for those with severe pain, weakness, or inability to feel their arms or legs. [emedicinehealth.com]

    We report a patient who presented with a severely destructive lesion and compression fracture at T9 with severe pain and impaired mobility. [ncbi.nlm.nih.gov]

    Vertebral compression fractures (VCFs) occur when the bony block or vertebral body in the spine collapses, which can lead to severe pain, deformity and loss of height. [aans.org]

  • Unable to Bend

    Later symptoms may include: Slowly worsening back pain — lying on your back may relieve the pain and standing may make it worse A decrease in your height Limited movement in your spine (unable to bend or twist) A stooped-over posture, called kyphosis. [cedars-sinai.org]

  • Amyloidosis

    Primary immunoglobulin light chain amyloidosis (AL amyloidosis) is a plasma cell disorder which mainly affects heart, kidneys, liver, and peripheral nervous system. [ncbi.nlm.nih.gov]

  • Wheelchair Bound

    In some cases the pain is so severe as to render the patient bed or wheelchair bound. What causes vertebral compression fractures? The vertebrae are usually weakened from a condition called osteoporosis, or thinning of the bone. [lamisinstitute.com]

Gastrointestinal

  • Constipation

    Despite the appearance of weight gain, the compression of the stomach causes weight loss, constipation and other problems. The crowding of internal organs can be very serious, even affecting lung function. [neurosurgicalassociatespc.com]

    This includes: liver or kidney damage, gastrointestinal bleeding, constipation, or narcotic dependence. [fairview.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]

Musculoskeletal

  • Back Pain

    VAS score for back pain and ODI were assessed at enrollment as well as at 2, 6, and 12 weeks after fracture. [ncbi.nlm.nih.gov]

    View other back pain conditions: Lower Back Pain Middle Back Pain Upper Back Pain Neck Pain Bulging Disc Herniated Disc Pinched Nerve Sciatica Facet Joint Syndrome Degenerative Disc Disease Foraminal Stenosis Sacroiliac (SI) Joint Dysfunction Failed Back [spineina.com]

  • Low Back Pain

    Compression fractures at the L5 level are rare; however, this problem should be considered in postmenopausal women who suffer from low back pain and in young men with a history of trauma. [ncbi.nlm.nih.gov]

    StraightHealthcare Home Return to low back pain [straighthealthcare.com]

    Prevalence of and Screening for Serious Spinal Pathology in Patients Presenting to Primary Care Settings With Acute Low Back Pain. Arthritis & Rheumatism. 2009; 60(10): 3072–3080. 2. Roman M, Brown C, Richardson W, Isaacs R, Howes C, Cook CE. [snyderphysicaltherapy.com]

    An 88-year-old woman with a 3-week history of severe low back pain. [ajnr.org]

  • Acute Low Back Pain

    Prevalence of and Screening for Serious Spinal Pathology in Patients Presenting to Primary Care Settings With Acute Low Back Pain. Arthritis & Rheumatism. 2009; 60(10): 3072–3080. 2. Roman M, Brown C, Richardson W, Isaacs R, Howes C, Cook CE. [snyderphysicaltherapy.com]

    Mechanical Low Back Pain (= Non-Specific Low Back Pain) = Any type of back pain in the lumbar region that is not related to serious pathology or does not have a specific cause. [physio-pedia.com]

    Prevalence of and screening for serious spinal pathology in patients presenting to primary care settings with acute low back pain. Arthritis Rheum. 2009;60(10):3072–80. pmid:19790051 View Article PubMed/NCBI Google Scholar 33. [journals.plos.org]

    Tapentadol immediate release versus oxycodone immediate release for treatment of acute low back pain. Pain Physician 2013; 16 ( 3 ):E237–E246 [ PubMed ] [ Google Scholar ] 22. Ballantyne JC, Mao J. Opioid therapy for chronic pain. [ncbi.nlm.nih.gov]

    Therefore, compression fracture should be suspected in any patient older than 50 years with acute onset of sudden low back pain. [aafp.org]

  • Spine Pain

    Peter Staats, National Spine & Pain Centers’ Chief Medical Officer, received the Lifetime Achievement Award at the 2019 Annual North American Neuromodulation Society (NANS) conference held January 17–20,… Read More Our team recently received an amazing [treatingpain.com]

    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]

    It brings immediate pain relief after compression fracture and preserves the natural shape of the spine, without the risks associated with major spine surgery. [joint-surgeon.com]

  • Decrease in Height

    The damaged vertebrae will decrease in height due to the fracture, and must decrease by at least 15% in order to be considered a VCF. [spineina.com]

    Symptoms of Osteoporotic Spinal Fractures Symptoms of Vertrebral Fracture Spine deformity results in a forward bent posture Reduced diameter of vertebral bodies decreases body height Static changes of the spine impairs mobility and balance Reduced height [joint-surgeon.com]

Psychiatrical

  • Type A Personality

    Because there is a substantial risk of subsequent fractures of all types in persons who have had a vertebral compression fracture, it is important that VCFs be diagnosed and treated early. [helpingbacks.com]

  • Claustrophobia

    Others were performed on low-field open MR imaging units due to patient claustrophobia issues. [ajnr.org]

Workup

[…] necessary for diagnosis useful to evaluate for acute vs chronic nature of compression fracture injury to anterior and posterior ligament complex spinal cord compression by disk or osseous material cord edema or hemorrhage Studies Laboratory a full medical workup [orthobullets.com]

Treatment

METHODS: A total of 98 patients undergoing non-operative treatment for recent single-level OVCF were reviewed retrospectively. [ncbi.nlm.nih.gov]

Prognosis

These cases are often characterized by indicators of good prognosis and show a relatively good treatment outcome. [ncbi.nlm.nih.gov]

Treatment and prognosis Management options include: non-surgical observation/bracing medications: bisphosphonates for osteoporosis surgical vertebroplasty [radiopaedia.org]

Outlook (Prognosis) Most compression fractures from trauma will heal in 8 - 10 weeks with rest, bracing, and pain medications. Recovery time will be many weeks longer if surgery is necessary. [gatewaypain.com]

Etiology

The possible etiology like osteoporosis or cancer metastasis should be included as a possibility in the differential diagnosis for severe back pain, to prevent delays in diagnosis and treatment. [ncbi.nlm.nih.gov]

[…] 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]

Patients with lumbar compression fractures usually present with kyphotic posture that is unlikely to be corrected, hip flexor contractures, and moderate pain at the level of the fracture. 3 Potential Etiologies The following are types of fractures that [morphopedics.wikidot.com]

Etiology of osteoporotic compression fractures Cortical and trabecular bone loss, as well as disruption of the microarchitecture of bone, are all typical of osteoporosis. [emedicine.medscape.com]

Epidemiology

The purpose of this paper is to discuss five cases of L5 vertebral compression fracture (VCF), illustrating the epidemiology, clinical presentation and radiographic appearance of the fracture at this uncommon site. [ncbi.nlm.nih.gov]

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]

Pathophysiology

In this Review, we summarise the evidence and predictive factors for VCF induced by spinal SBRT, review the pathophysiology of VCF in the metastatic spine, and discuss strategies used to prevent and manage this potentially disabling complication. [ncbi.nlm.nih.gov]

The pathophysiology of this injury pattern is dependent on the axis of flexion. Several subtypes exist, and each is dependent on the axis of flexion and on the number and degree of column failure. [emedicine.medscape.com]

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]

[…] are associated with pain and disability. 4.To study alterations in the kinematic and muscular activity in the thoracolumbar spine that might help clarify the long-lasting pain and disability after an acute compression fracture. 5.To determine if the pathophysiological [researchweb.org]

Prevention

Teriparatide was better than alendronate at improving bone mineral density and bone turnover parameters, as well as preventing aggravation of spinal cord compromise. [ncbi.nlm.nih.gov]

Apart from preventing VCF or another VCF, treatment of osteoporosis also aims to prevent other fractures, particularly hip fractures. [bsir.org]

Prevention 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. [mountsinai.org]

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