11/18/2023 0 Comments Compression fracture in back![]() Strength of the vertebral body is largely dependent upon the strength of its trabecular bone. ![]() Regardless of the etiology, compression fractures occur when the load on the bone exceeds the vertebral body’s strength to withstand excessive stress. 6 Breast and prostate cancer patients that receive adjuvant hormone therapy with aromatase inhibitors, and androgen deprivation therapy, respectively, suffer bone loss, increasing their risk of fracture. Up to 30% of patients with skeletal metastases may experience pathologic vertebral fractures. Primary tumors such as multiple myeloma and lymphoma may result in this condition as well. Metastases arising from breast, lung, prostate, and thyroid carcinomas are well known to cause pathologic fractures of the spine. Peaks are seen in age groups between 15 to 29 and greater than 65. Traumatic fractures affecting the thoracolumbar spine most commonly occurs after blunt trauma, and the incidence ranges from 2-6 percent of those who sustain such an injury. Premenopausal calcium intake may be just as important as that amount taken postmenopausally. Primary prevention includes avoiding first and secondhand smoke, participation in regular weight-bearing exercise, lowering alcohol consumption as well as increasing calcium and vitamin D intake. Those at increased risk include post-menopausal woman, smokers, thin or frail individuals with low body fat or those with chronic steroid useage. Over 750,000 new osteoporotic VCFs occur each year in the United States, over a third of which become chronically painful. Prevalence of osteoporotic VCFs in people between the ages of 50-79 is anywhere between 12%-40%. Epidemiology including risk factors and primary prevention Traumatic VCFs may result from high-energy trauma such as a motor vehicle accident, fall from height, violent act, or gunshot wound. On the other hand, pathologic insufficiency VCFs are due to weakening of bone density as a result of a bony destructive factor such as primary or metastatic bone cancer or osteomyelitis. By definition, there is no infiltration into bone by any extra-osseous process. 2 Osteoporotic VCFs occur as a result of a natural decrease in bone density related to osteoporosis and aging. Among these, osteoporosis is the most common cause of VCFs. VCFs may result from osteoporosis, malignancy, infection, or trauma. Vertebral Compression Fractures (VCF) are defined as a height loss of 4 mm or 20% loss from baseline resulting from a failure of the trabecular meshwork within the vertebrae.
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