Vertebral Fractures
Vertebral Compression Fracture Symptoms
Sudden and severe pain out of proportion to the activity at hand, is a hallmark sign of a spinal fracture. This may occur after a minor fall, coughing, bending over or even while you are sleeping.
The pain tends to be in the lower or mid back but may occur in the upper back as well depending on the location of the fracture.
Numbness, tingling, and weakness: Numbness, tingling, and weakness most likely occur because the fractured vertebrae is compressing nerves at the fracture sight.
Losing control of urine or stool or inability to urinate: These symptoms are present when the fractured vertebrae are pushing on the spinal cord itself.
Many patients mistakenly attribute the pain of a spinal fracture to a muscle strain or bad back and thus do not seek medical attention until the pain doesn't resolve
The pain tends to be debilitating and immobilizing and it is often difficult to find a comfortable position and can last indefinitely and may require hospitalization and narcotics for pain control.
The overwhelming majority of vertebral compression fractures are due to osteoporosis.
Due to the lack of estrogen, post menopausal women, usually 70 years of age and older, are four times as likely to develop osteoporosis than men.
If not prevented or if left untreated, osteoporosis can progress painlessly until a bone breaks.
150,000 patients are hospitalized yearly due to vertebral compression fractures (VCFs) due to osteoporosis.
The average hospital stay is 8 days. Medical costs (in total) exceed $1.6 billion per year.
Osteoporosis may be diagnosed by a radiologist by doing a simple scan, to calculate the bone mineral density (BMD). Typically the exam includes scans of the spine and the hips.
Once the bone density is determined, the degree of osteoporosis can be quantified and the future risk of a spine fracture can be predicted.
There are various treatments for osteoporosis that are effective and if treated is instituted, osteoporosis may improve and the fracture risk will be reduced.
The earlier osteoporosis is detected and treated, the better will be the treatment effects and thus decreasing the likelihood of compression fractures.
Osteoporosis
Medications used to treat osteoporosis:
Medications listed below are approved by the FDA to prevent and/or treat osteoporosis.
Antiresorptive Medications
"Bisphosphonates"
Alendronate and alendronate plus vitamin D3 (Brand names Fosamax and Fosamax plus D)Ibandronate (brand name Boniva)Risedronate and risedronate with calcium (brand name Actonel & Actonel with calcium)Zoledronic Acid (brand name Reclast)Other Antiresorptive Medications
Calcitonins (brand name Fortica & Miacalcin)Estrogen therapy, estrogen and progesterone hormone therapy (multiple brand names)Estrogen Agonists/Antagonists as know as Selective Estrogen Receptor Modulators (SERMs) Raloxifene (brand name Evista)Bone Forming (Anabolic) Medications
Parathyroid HormoneTeriparatide (brand name Forteo)Treatment
Copyright © 2008, Joel Garris MD, FACR. All rights reserved.
INTERVENTIONAL RADIOLOGY
Minimally Invasive Alternatives to Surgery
