Vertebral Compression Fractures

 
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III.A.1.1

Lead Author(s): 

Sigurd H. Berven, MD
Matthew D. Hepler, MD

Supporting Author(s): 

Sylvia I. Watkins-Castillo, PhD

Vertebral compression fractures are most commonly low-energy injuries that occur in patients with underlying osteopenia or osteoporosis. They affect between 700,000 and 1,000,000 persons in the US annually, and 25% of woman in their lifetime.1,2 Many low-energy fractures are treated nonsurgically with a short period of bed rest, pain medications, bracing, and therapy. Approximately 30% to 40% of patients, however, develop disabling pain and/or deformity (kyphosis), resulting in 150,000 hospitalizations annually. Frequently, patients with VCF also have reduced pulmonary function (FVC), increased risk of mortality (compared to age-matched controls), and a lower 5-year survival when compared to hip fracture patients.3 Treatment of symptomatic VCF with vertebral augmentation (vertebroplasty or kyphoplasty) has been shown in various studies to be a cost-effective intervention that both decreases pain and improves survival.4,5,6 Various strategies have been employed to prevent and treat the osteoporosis that predisposes to these “fragility fractures” and is further discussed in the Osteoporosis chapter.

  • 1. Edidin AA, Ong KL, Lau E, Kurtz SM: Life expectancy following diagnosis of a vertebral compression fracture. Osteoporosis Int 2013 Feb;24(2):451-458.
  • 2. Riggs BL, Melton LJ: The worldwide problem of osteoporosis: Insights afforded by epidemiology. Bone 1995;5055–5115.
  • 3. Kado DM, Browner WS, Palermo L, Nevitt MC, Genant HK, Cummings SR: Vertebral fractures and mortality in older women: A prospective study. Study of Osteoporotic Fractures Research Group. Arch Intern Med 1999;159,1215–1220.
  • 4. Svedbom, A, et al: Balloon kyphoplasty compared to vertebroplasty and nonsurgical management in patients hospitalized with acute osteoporotic vertebral compression fracture: a UK cost-effectiveness analysis. Osteoporos Int, 2012.
  • 5. Garfin SR, Reilley MA: Minimally invasive treatment of osteoporotic vertebral body compression fractures. The Spine Journal 2002(2):76-80.
  • 6. Edidin AA, Ong KL, Lau E, Kurtz SM: Mortality risk for operated and non-operated fracture patients in the Medicare population. JBMR, 2011 Jul;26(7):1617-1626.

Edition: 

  • 2014

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