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J Clin Outcomes Manage
2011 Dec;18(12):571-581
Diagnosis and treatment of osteoporotic compression fractures of the spine
MacKenzie SP
ABSTRACT: Objective: To review the diagnosis and treatment of osteoporotic vertebral compression fractures. Methods: Literature review. Results: Osteoporotic compression fractures of the spine are a relatively common cause of back pain, especially in elderly individuals. Approximately 700,000 new vertebral compression fractures occur in the United States every year. Pain is the most common presenting symptom and can occur anywhere in the spine, with the lower thoracic and upper lumbar regions being most common. An x-ray is often the simplest test that will confirm the presence of an osteoporotic compression fracture. They are best seen in the lateral view. Initial treatment of an osteoporotic compression fracture focuses on pain control and avoiding disability. For a wedge or stable burst fracture, heat, massage and relative rest are often beneficial. For unstable fractures, surgical intervention is often required. Vertebroplasy and kyphoplasty are 2 minimally invasive procedures that can be employed for osteoporotic compression fractures. In addition to treatment of the osteoporotic compression fracture, the clinician must look at treating the underlying osteoporosis. Physical medicine and rehabilitation intervention is an emerging therapy for osteoporosis management. Conclusion: For patients who have osteoporotic vertebral compression fractures, identification of the fracture and assessment of the type of fracture are essential to proper treatment. Very few osteoporotic vertebral compression fractures will require surgery. Treatment of the underlying osteoporosis is also essential for successful long-term patient functioning.
Case-Based Review
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