A spinal compression fracture is the collapse of the vertebral body caused by trauma, osteoporosis, infection, or tumors. Patients experience sudden localized back pain that worsens with movement. Diagnosis involves x-rays, CT scans, and MRI (with STIR sequence) to identify the fracture and determine its acuity. Conservative treatment includes medications and bracing, while vertebroplasty and kyphoplasty are minimally invasive surgical options to stabilize acute fractures by injecting bone cement. Vertebroplasty directly fills the fracture with cement, while kyphoplasty first uses a balloon to elevate the fracture before cement injection.

1. Diagnosis & Managment

2. What is a Spinal Compression
Fracture?
A spinal compression fraction is the
collapse if the Vertebral Body of a spinal
Vertebra
.

3. Etiology
 Trauma
 Osteoporosis/Osteopenia (bone density
loss)
 Osteomyelitis (Bone infection)
 Pathologic Fractures (Primary or
Metastatic Tumors)

4. Symptoms
 Patients usually report sudden onset of
localized Back pain which may range
from mild to severe.
 Rarely associated with radicular
symptoms (pain, numbness or tingeling
involving the anterior chest or abdominal
wall, or traveling down an extremity)
 Pain made worse with movement,
improved with remaining still

5. Diagnosis

6. Plain Radiograph
(X-Ray)
Plain X-Ray can be
utilized to diagnose the
Presence of Compression
fracture in the Lumbar or
Cervical spine.
Visualization in Thoracic
spine is difficult. Cannot
be utilized to determine
Acuity

7. Cat
Scan
Computer Aided
Tomography (CAT scan)
is a wonderful tool to
utilize to diagnose
Compression fractures
anywhere within the
spinal column. Cannot
identify Acuity of fracture

8. MRI with
STIR
sequence
Magnetic Resonance
Imaging (MRI) is probably
the best diagnostic tool, in
that it will readily identify
the presence of a
Compression fracture, AND
determine acuity if STIR
sequence is added. STIR
sequence identifies
surrounding edema,
present in acute fractures

9. Nuclear
Medicine
Bone
Scan
Bone Scan can be
utilized in conjunction
with other diagnostic
imaging studies to
determine acuity, but is
limiting when utilized
alone for diagnostic
purposes

10. Conservative Treatment
Medications – NSAIDS,
Opioids, possibly Calcitonin
Back Braces – LSO,
TLSO, Clam Shell

11. Surgical Options
***Should only be considered if fracture is Acute***
 Vertebroplasty – minimally invasive,
percutaneous injection of bone cement
into the vertebral body for stabilization
 Kyphoplasty – minimally invasive,
percutaneous balloon reduction of
fraction and internal fixation by injection
of bone cement for stabilization

12. Vertebroplast
y
Vertebroplasty places a
small trocar, through
the skin, down the
pedicle of the Vertebra
in order to fill the
fracture with cement.
No attempt is made to
reduce the fracture

13. Kyphoplast
y
Kyphoplasty inserts a
trocar through the skin
for placement of a
balloon, in order to
elevate the fracture.
The balloon is
subsequently removed,
and the void filled with
bone cement