Lumbar Compression fractures
Complete list of fracture information
The lumbar area of the spine is the lower section or lower part of the back.Lumbar
Compression fractures occur when the vertebrae in the spine collapse from their normal
height of an inch or so to about half that size.
General information about Lumbar Compression fractures
Vertebrae are the bones of the back. In a compression fracture
of the vertebrae, the bone tissue of the vertebral body collapses. More than one vertebra
may be affected. This condition may be caused by osteoporosis (the most common cause),
tumor, or trauma to the back.
When the fracture occurs as a result of osteoporosis, the vertebrae in the thoracic
(chest) and lower spine are usually affected, and symptoms may be worse with walking.
With multiple fracture skyphosis, a forward hump-like curvature of the spine (think the
Hunchback of Notre Dame) may result. Pressure on the spinal cord may occur producing
symptoms of numbness, tingling, or weakness. Symptoms depend upon the area of the back
that is affected, however, most fractures are stable and do not produce neurological
symptoms.
Diagnoisis of Lumbar Compression fractures
Physical examination may show kyphosis.
There is also tenderness over the injured vertebrae.
A spine X-ray shows at least one compressed vertebra that is shorter than the other
vertebrae.
If there is no history of significant trauma, a bone density test needs to be done to
evaluate for osteoporosis.
If there is concern that the fracture was caused by a tumor eating and weakening the
bone, a CT or MRI scan is necessary to get a better look at the bone. Also, if the
fracture was caused by high energy trauma (fall from a height, car accident, etc.) then a
CT scan is needed to see if there are bone fragments pressing on the spinal cord.
Treatment of Lumbar Compression fractures
Most Lumbar Compression fractures are found in elderly patients
with osteoporosis. These fractures generally do not cause injury to the spinal cord.
Treatment includes treating the osteoporosis with prescription medications and
supplemental calcium.
Otherwise, these fractures are treated symptomatically with pain medicines. Some
practitioners employ back braces, but these may weaken the bones more and predispose the
patients to more fractures in the future.
While surgery is rarely needed, there is a new, minimally invasive technique that can
help patients with intractable pain from osteoporotic Lumbar Compression fractures. A
large needle is inserted with X-ray guidance into the compressed vertebra. A balloon is
inserted into the bone through the needle and inflated, restoring the height of the
vertebra. Sometimes, cement is injected into the bone to make sure it does not collapse
again.
If the fracture is caused by tumor, the tumor may need to be biopsied (a piece of bone
surgically removed and examined under a microscope to determine the nature of the tumor)
and treated.
Fractures from trauma often require rigid bracing to protect the bone as it heals for 6
to 10 weeks. If there is bone in the spinal canal, surgery to remove the bone and fuse the
vertebra together to stabilize the spine may be necessary.
Surgery is almost always necessary if there is any loss of function because of bone
pressing on the spinal cord or spinal nerves. |
