Compression fracture

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Compression fracture
Classification and external resources
L4 compressionFracture2008.jpg
Compression fracture of the fourth lumbar vertebra post falling from a height.
ICD-9733.13 (pathological), 805-806 (traumatic)
 
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Compression fracture
Classification and external resources
L4 compressionFracture2008.jpg
Compression fracture of the fourth lumbar vertebra post falling from a height.
ICD-9733.13 (pathological), 805-806 (traumatic)
X-ray of the lumbar spine with a compression fracture of the third lumbar vertebra.

A compression fracture is a collapse of a vertebra. It may be due to trauma or due to a weakening of the vertebra (compare with burst fracture). This weakening is seen in patients with osteoporosis or osteogenesis imperfecta, lytic lesions from metastatic or primary tumors,[1] or infection.[2] In healthy patients it is most often seen in individuals suffering extreme vertical shocks, such as ejecting from an ejection seat. Seen in lateral views in plain x-ray films, compression fractures of the spine characteristically appear as wedge deformities, with greater loss of height anteriorly than posteriorly and intact pedicles in the anteroposterior view.[3]

Symptoms[edit]

Acute fractures will cause severe back pain. Compression fractures which develop gradually, such as in osteoporosis, may initially not cause any symptoms, but will later often lead to back pain and loss of height.

Diagnosis[edit]

Compression fractures are usually diagnosed on spinal radiographs, where a wedge-shaped vertebra may be visible or there may be loss of height of the vertebra. In addition, bone density measurement may be performed to evaluate for osteoporosis. When a tumor is suspected as the underlying cause, or the fracture was caused by severe trauma, CT or MRI scans may be performed.

Treatment[edit]

Conservative treatment[edit]

Surgical[edit]

Additional images[edit]

References[edit]

  1. ^ Weber, Kristy (February 28, 2006). "Rounds 2: Treatment of Metastatic Bone Disease". John Hopkins Arthritis Center. 
  2. ^ "Bone Infections". MedlinePlus. September 7, 2011. 
  3. ^ Brant, William E.; Helms, Clyde A. (2007). "Benign Compression Fracture". Fundamentals of Diagnostic Radiology (3rd ed.). Philadelphia: Lippincott Williams & Wilkins. p. 302. ISBN 978-0-7817-6135-2. 
  4. ^ "Jewett vs. TLSO Replies". OANDP-L on oandp.com. 2010-09-27. Retrieved 2012-09-02. 
  5. ^ "Calcitonin for osteoporotic fractures". Retrieved 2012-09-03. 
  6. ^ Knopp, Jennifer A.; Diner, Barry M.; Blitz, Maurice; Lyritis, George P.; Rowe, Brian H. (2004). "Calcitonin for treating acute pain of osteoporotic vertebral compression fractures: A systematic review of randomized, controlled trials". Osteoporosis International 16 (10): 1281–90. doi:10.1007/s00198-004-1798-8. PMID 15614441. 
  7. ^ a b Taylor, Rod S.; Taylor, Rebecca J.; Fritzell, Peter (2006). "Balloon Kyphoplasty and Vertebroplasty for Vertebral Compression Fractures". Spine 31 (23): 2747–55. doi:10.1097/01.brs.0000244639.71656.7d. PMID 17077747. 
  8. ^ Taylor, Rod S.; Fritzell, Peter; Taylor, Rebecca J. (2007). "Balloon kyphoplasty in the management of vertebral compression fractures: An updated systematic review and meta-analysis". European Spine Journal 16 (8): 1085–100. doi:10.1007/s00586-007-0308-z. PMC 2200787. PMID 17277923. 
  9. ^ Kallmes, David F.; Comstock, Bryan A.; Heagerty, Patrick J.; Turner, Judith A.; Wilson, David J.; Diamond, Terry H.; Edwards, Richard; Gray, Leigh A. et al. (2009). "A Randomized Trial of Vertebroplasty for Osteoporotic spinal Fractures". New England Journal of Medicine 361 (6): 569–79. doi:10.1056/NEJMoa0900563. PMC 2930487. PMID 19657122. 
  10. ^ Buchbinder, Rachelle; Osborne, Richard H.; Ebeling, Peter R.; Wark, John D.; Mitchell, Peter; Wriedt, Chris; Graves, Stephen; Staples, Margaret P.; Murphy, Bridie (2009). "A Randomized Trial of Vertebroplasty for Painful Osteoporotic Vertebral Fractures". New England Journal of Medicine 361 (6): 557–68. doi:10.1056/NEJMoa0900429. PMID 19657121. 
  11. ^ Boonen, S.; Wahl, D. A.; Nauroy, L.; Brandi, M. L.; Bouxsein, M. L.; Goldhahn, J.; Lewiecki, E. M.; Lyritis, G. P. et al. (2011). "Balloon kyphoplasty and vertebroplasty in the management of vertebral compression fractures". Osteoporosis International 22 (12): 2915–34. doi:10.1007/s00198-011-1639-5. PMID 21789685. 
  12. ^ Han, Shiliang; Wan, Shuanglin; Ning, Lei; Tong, Yongjun; Zhang, Jianfeng; Fan, Shunwu (2011). "Percutaneous vertebroplasty versus balloon kyphoplasty for treatment of osteoporotic vertebral compression fracture: A meta-analysis of randomised and non-randomised controlled trials". International Orthopaedics 35 (9): 1349–58. doi:10.1007/s00264-011-1283-x. PMC 3167445. PMID 21637959. 
  13. ^ Farrokhi, Majid Reza; Alibai, Ehsanali; Maghami, Zohre (2011). "Randomized controlled trial of percutaneous vertebroplasty versus optimal medical management for the relief of pain and disability in acute osteoporotic vertebral compression fractures". Journal of Neurosurgery: Spine 14 (5): 561–9. doi:10.3171/2010.12.SPINE10286. PMID 21375382. 

External links[edit]