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Vertebral Compression Fractures

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Fractures in the Elderly

Part of the book series: Aging Medicine ((AGME))

Abstract

Vertebral compression fractures (VCFs) are the most common fragility fractures that affect the elderly population in the United States. Osteoporosis is a significant risk factor for VCFs which affects white females at a disproportionately greater rate than any other demographic group. The microarchitectural changes in the cancellous and cortical bone of the vertebral bodies predispose to failure of the anterior column at near-physiologic compressive loading. While the majority of VCFs are asymptomatic, persistent back pain with routine activities is a common presenting symptom. Nonsteroidal anti-inflammatory medications, bracing, and low-dose narcotic medications are effective in treating most patients who have symptomatic VCFs. Preventative measures, including vitamin D and calcium supplementation, as well as bone mineral density screening and pharmacotherapy for osteoporosis, can significantly decrease the risk of VCFs. Percutaneous reduction and injection of polymethyl methacrylate have shown some promise in relieving pain from VCFs, though results in the literature have been variable and the ideal indications for such interventions remain controversial.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Pennsylvania School of Medicine, Penn Medicine University City, Philadelphia, PA, USA

    Andrew H. Milby & Harvey E. Smith

  2. Department of Spine Health, The CORE Institute, Gilbert, AZ, USA

    Ejovi Ughwanogho

  3. Spinal Neurosurgery, Neurological Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates

    Nader M. Hebela

  4. Department of Surgery, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Abu Dhabi, United Arab Emirates

    Nader M. Hebela

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  1. Andrew H. Milby
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  2. Ejovi Ughwanogho
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  3. Nader M. Hebela
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  4. Harvey E. Smith
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Correspondence to Andrew H. Milby .

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  1. Chair, Geriatric Medicine and Gerontology, Robert and Arlene Kogod Professor of Geriatric Medicine, Department of Medicine, Mayo Clinic School of Medicine, Rochester, Minnesota, USA

    Robert J. Pignolo

  2. Co-Director, Orthopaedic Trauma & Fracture Reconstruction, Advisory Dean, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA

    Jaimo Ahn

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Milby, A.H., Ughwanogho, E., Hebela, N.M., Smith, H.E. (2018). Vertebral Compression Fractures. In: Pignolo, R., Ahn, J. (eds) Fractures in the Elderly. Aging Medicine. Humana Press, Cham. https://doi.org/10.1007/978-3-319-72228-3_11

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