What it is
Vertebral compression fractures occur when a vertebral body collapses under load. The most common cause in older adults is osteoporosis — weakened bone that cannot withstand normal mechanical forces. Fractures can also result from trauma, cancer metastasis to the vertebral body, or other conditions that weaken bone.
These fractures are common: an estimated 750,000 occur in the United States each year, and they often go undiagnosed because many patients attribute back pain to muscle strain or arthritis.
Management
Most compression fractures — particularly those that are stable, without neurological involvement, and in the setting of osteoporosis — improve with conservative management over 6–12 weeks. Pain management, limited activity modification, and sometimes a brace to reduce vertebral loading are the mainstays.
Kyphoplasty and vertebroplasty
When pain is severe, the fracture is recent (typically within 6–8 weeks), and conservative management is not providing adequate relief, minimally invasive cement augmentation procedures — kyphoplasty or vertebroplasty — can be considered.
Kyphoplasty involves inserting a balloon into the collapsed vertebra, inflating it to restore some height, then filling the space with bone cement. The procedure can provide rapid and significant pain relief in appropriate candidates.
Cement augmentation is not appropriate for all fractures. Fractures with significant spinal cord or nerve root compression from displaced bone may require more complex surgical stabilization.
Bone health treatment — to prevent future fractures — is an essential and often overlooked component of comprehensive management.