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Vertebral Compression Fractures

  • Andrew H. MilbyEmail author
  • Ejovi Ughwanogho
  • Nader M. Hebela
  • Harvey E. Smith
Chapter
Part of the Aging Medicine book series (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.

Keywords

Vertebral compression fractures Vertebroplasty Kyphoplasty Anterior column fracture Elderly and geriatric compression fractures 

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© Springer Science+Business Media, LLC 2018

Authors and Affiliations

  • Andrew H. Milby
    • 1
    Email author
  • Ejovi Ughwanogho
    • 2
  • Nader M. Hebela
    • 3
    • 4
  • Harvey E. Smith
    • 1
  1. 1.Department of Orthopaedic SurgeryUniversity of Pennsylvania School of Medicine, Penn Medicine University CityPhiladelphiaUSA
  2. 2.Department of Spine HealthThe CORE InstituteGilbertUSA
  3. 3.Spinal NeurosurgeryNeurological Institute, Cleveland Clinic Abu DhabiAbu DhabiUnited Arab Emirates
  4. 4.Department of SurgeryCleveland Clinic Lerner College of Medicine of Case Western Reserve UniversityAbu DhabiUnited Arab Emirates

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