Vertebral Compression Fracture

A vertebral compression fracture is a collapse of one of the building blocks of the spine — the vertebral body — most often in the mid or lower back. In bone weakened by osteoporosis, the "injury" can be startlingly minor: a cough, a misstep off a curb, lifting a grocery bag. Sometimes there is no remembered event at all.

The classic pain is sudden, focal, and position-dependent — sharp with standing, rolling over, or transferring, better lying still. Some fractures, though, cause little pain and are discovered later as lost height or a forward stoop; each fracture increases the load on its neighbors, which is how one becomes several.

Two causes deserve special mention: fractures in bone weakened by cancer (pathologic fractures), and fractures after real trauma. Both are evaluated differently, and both are part of why a new compression fracture always deserves an actual diagnosis rather than an assumption.

The evaluation confirms the fracture and, importantly, its age — an MRI distinguishes a fresh fracture from an old healed one, which changes everything about treatment. When the story or imaging raises questions, we look for an underlying cause, including cancer and bone disease.

Many fractures heal with conservative care over several weeks: pain control, early mobilization (prolonged bed rest is the enemy of older bones), and sometimes a brace for comfort. We follow you through it rather than sending you off with a prescription.

The most important long-term step happens outside the operating room: treating the osteoporosis. A compression fracture is the skeleton announcing a problem, and the bone-health workup and treatment — often with your primary physician or endocrinology — is how we prevent the next one.

When a fresh fracture remains severely painful after a few weeks of conservative care — or when pain is preventing the mobility an older patient cannot afford to lose — kyphoplasty offers immediate stabilization: cement placed percutaneously through two small punctures, typically as an outpatient, with relief that is often dramatic and fast.

Open surgery is reserved for the uncommon fracture that is unstable, compressing the spinal cord, or collapsing progressively — situations where stabilization or reconstruction, not just cement, is required.