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]
Hematological
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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
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Severe Pain
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]
Surgery is normally reserved for those with severe pain, weakness, or inability to feel their arms or legs. [emedicinehealth.com]
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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]
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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]
Gastrointestinal
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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]
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Failure to Thrive
[…] to thrive and constitutional symptoms younger patient with no history of fall Treatment Nonoperative observation, bracing, and medical management indications majority of patients can be treated with observation and gradual return to activity PLL intact [orthobullets.com]
Musculoskeletal
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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]
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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]
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]
Vertebral fractures may appear as low back pain, loss of height, or spinal deformities such as kyphosis. Symptoms can be damaging to a patient’s quality of life. [my.clevelandclinic.org]
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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]
Nonsurgical treatment of osteoporotic compression fracture of the spine Pain Medication Medication to increase bone density Physiotherapy to activate calcium metabolism Biomechanical Stimulation (BMS or Matrix-Therapy ZRT) to stimulate the calcium metabolism [joint-surgeon.com]
At the time of discharge, the patient had minimal thoracic spine pain and trace lower extremity edema. [casesjournal.biomedcentral.com]
Doctors also check for other injuries, such as heel fractures and additional fractures in the spine. [msdmanuals.com]
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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]
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]
Assessment and management of acute low back pain. Am Fam Physician. 1999;60:2299–308. 20. Schultz RJ. The language of fractures. Baltimore: Williams & Wilkins, 1990. 21. Predey TA, Sewall LE, Smith SJ. [aafp.org]
L2 spinal nerve-block effects on acute low back pain from osteoporotic vertebral fracture. J Pain 2009;10(8):870-5. LoE: 1b Bennell KL, Matthews B, Greig A, Briggs A, Kelly A, Sherburn M, Larsen J, Wark J. [physio-pedia.com]
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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
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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]
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Claustrophobia
Others were performed on low-field open MR imaging units due to patient claustrophobia issues. [ajnr.org]
Neurologic
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Convulsions
Nocturnal vertebral compression fractures may be the presenting feature of unwitnessed convulsive seizures, and evaluation for epilepsy should be considered in cases of idiopathic vertebral compression fractures. [ncbi.nlm.nih.gov]
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]
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]
Outlook (Prognosis) Most compression fractures due to injury heal in 8 to 10 weeks with rest, wearing of a brace, and pain medicines. However, recovery can take much longer if surgery was done. [mountsinai.org]
[…] definition WHO defines osteoporosis as T score below -2.5 Associated conditions compromised pulmonary function increased kyphosis can affect pulmonary function each VCF leads up to 9% reduction in FV increased risk of mortality from pulmonary dysfunction Prognosis [orthobullets.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]
[…] 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]
Epidemiology of spinal osteoporosis. Spine. 1997;22(24 Suppl):2S–11S. ... 2. Melton LJ 3d, Kan SH, Frye MA, Wahner HW, O'Fallon WM, Riggs BL. Epidemiology of vertebral fractures in women. Am J Epidemiol. 1989;129:1000–11. 3. [aafp.org]
Epidemiology of vertebral fractures in women. Am J Epidemiol. 1989;129(5):1000–11. pmid:2784934 View Article PubMed/NCBI Google Scholar 4. Cooper C, O'Neill T, Silman A. The epidemiology of vertebral fractures. [journals.plos.org]
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]
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]
Back to top Prevention and treatment of VCF Prevention and treatment of osteoporosis Treatment of tumours Pain relief for VCF Back to top Prevention and treatment of osteoporosis Osteoporosis is one of the main causes of VCF but not everyone with osteoporosis [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]