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Osteoporosis and spine fracture

Spine fractures, also called vertebral compression fractures, usually happen when the front of the vertebra collapses, often caused by osteoporosis.

This can cause the spine to become curved affecting the person's height. They may also experience pain, breathing problems, gastrointestinal problems and disturbed sleep.

Vertebral fractures are more common in women, and the risk increases with age.

The most effective way to prevent vertebral compression fractures is to prevent and treat osteoporosis.

In some cases, pain from a spinal fracture can be so debilitating that you have great difficulty making small movements. Spinal fractures make any position (standing or sitting) very uncomfortable. Spine fractures can also cause you to lose your independence. Many patients with spinal fractures can no longer care for themselves.

Who’s at greatest risk of spine fractures?

Women, especially those older than 50, are at greatest risk of spine fractures.

Men can also have a spinal fracture, and women and men who have osteoporosis have an even greater risk of spinal fractures.

Age plays a big role in spinal fractures. As you age, your bones may become increasingly thinner and weaker. This is especially true if you have osteoporosis. The tremendous effort required to just hold your body erect can be enough to cause a spinal fracture.

Elderly adults with osteoporosis can stress their weak spines with constant bending. This bending causes pressure on the back that is equivalent to several times the weight of the body. This greatly increased pressure can lead to a spinal fracture.

What are the symptoms of a spinal fracture?

Although many patients report some type of back pain, only one third of spinal fractures actually produce painful symptoms. That makes early diagnosis of spine fractures extremely difficult. Fractures in the lower spine are associated with greater pain and loss of function than are fractures of the upper spine.

Symptoms of a spinal fracture may include:

  • Sudden, severe back pain
  • Worsening of pain when standing or walking
  • Difficulty and pain when bending or twisting
  • Loss of height
  • Deformity of the spine, the curved, "hunchback" shape also known as dowager’s hump

It is possible to fracture more than one bone in the spine. This can result in pain that lasts longer than a few weeks. If this happens to you and you have severe pain for longer than a few days, seek medical advice. There may be an additional problem in your spine. Also, seek medical advice if you notice a change in your bladder or bowel habits.

What’s the treatment for spine fractures?

An X-ray scan or a computed tomography (CT) scan is typically used to determine whether or not you have a spinal fracture. Your doctor will analyse the image of your spine and determine the severity of the fracture.

Your GP may also arrange for you to have a bone mineral density (BMD) scan, also called a DXA scan.

Treatment may include stabilisation of the spine with a brace. Some fractures may need surgery. It depends on how severe the fracture is.

The aim of treatment is to restore mobility, reduce pain and minimise the risk of new fractures.

Vertebroplasty and kyphoplasty are two treatments that can help to strengthen fractured bone and reduce pain.

Percutaneous vertebroplasty involves injecting acrylic bone cement into the spine to relieve pain, stabilise the fractured vertebrae and possibly restore lost height.

Balloon kyphoplasty is carried out by inserting a balloon-like device through a channel drilled in the fractured vertebrae. The balloon is inflated slowly until normal height is restored or the balloon is fully inflated.

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