Vertebral fracture

Osteoporosis is associated with an abnormal decrease in bone density. This can lead to vertebral fractures. This generally affects vertebrae in the thoracic spine or lumbar spine. Where bone density is reduced, a small amount of force is often sufficient to cause fractures. 

Vertebral fracture

A quick overview:

Vertebral fracture with osteoporosis

Normally, vertebral fractures are the result of large forces, for example those that come with a fall. Another cause of vertebral fractures can be the metabolism-related skeletal condition osteoporosis. This leads, for example, to reduced bone mass and increased susceptibility to fractures of the thoracic spine and lumbar spine. Bone tumours and metastases can also lead to bones breaking more easily.

The bone density describes the ratio of mineralised bone mass to defined bone volume. In osteoporosis, both density and mass reduce – and not only in older people. In the event a patient has experienced their first vertebral fracture, therapy measures should be introduced to ensure that subsequent fractures can be prevented where possible.

Symptoms of a vertebral fracture: Recognising the signs of a vertebral fracture

A vertebral fracture rarely goes unnoticed because it is generally painful. Before the doctor does an X-ray to reach a precise diagnosis, signs may point to a vertebral fracture:

  • pain caused for example by pressure, tapping and compression in the affected section
  • Elevation or palpable gaps in the line of the spinous process
  • Limited range of spinal movement
  • Adaptive posture
  • Hardening of the muscles

If the spinal cord is affected, associated disorders below the level of the fracture or neurological failures may follow:

  • Bladder and rectal control disorders
  • Sensory disturbances
  • Hyper-elevated or weakened reflexes
  • Signs of paralysis

Vertebral fractures can occasionally be completely symptom-free!

Therapy for vertebral fracture: non-surgical or surgical

A vertebral fracture is treated by a doctor, in this case an orthopaedic expert, non-surgically or surgically depending on the type of fracture, extent of damage and impairment of the patient.

The most suitable therapy depends on the individual case – whether, for example, the fracture is stable or unstable. The age of the patient, their overall condition, the presence or extent of chronic pain and their personal preferences also, however, play a role.

Non-surgical treatment for vertebral fractures

If a fracture is stable, non-surgical treatment is used initially as a rule.

For acute, stable osteoporotic vertebral fractures, in its therapy guideline developed by doctors the Osteology Umbrella Organisation (DVO) recommends using a spine-straightening orthosis, for example (information at https://dv-osteologie.org/). The Spinomed back orthoses by medi are therefore an important therapeutic component in osteoporosis therapy

Surgical treatment of vertebral fractures

In osteoporotic vertebral fractures, the fractured vertebrae can be surgically stabilised. Two procedures are generally used here.

Vertebroplasty: Bone cement is injected into the fractured vertebra from where it then spreads throughout the healthy bone structure. Osteoporosis medication (e.g. bisphosphonates) can also have an effect on these intact structures.

Kyphoplasty: In this procedure, the surgeon inserts a balloon into the fractured vertebra. This is then filled with bone cement, which partially straightens and stabilises the vertebra. In contrast to vertebroplasty, the remaining bone structure in the vertebral body is destroyed by the balloon. 

Products by medi: Spinomed back orthoses

Previously, osteoporosis patients wore a stiff corset after a vertebral fracture. Nowadays there are back orthoses which adapt to the patient’s natural movements, fit securely and are comfortable to wear. 

These spine-straightening orthoses can be prescribed by a doctor if necessary. The effectiveness of Spinomed back orthoses have been confirmed in two clinical studies. One effect is that the back orthosis strengthens the muscles and can relieve pain: As a result of the tension effect, the back muscles and stomach tense in a reflexive manner (= biofeedback). The tendency to sway and the risk of falls and possible subsequent fractures can be reduced and breathing improved. 1,2 ​​​​​​​

Further building blocks of osteoporosis therapy in accordance with the guidelines are medication and movement concepts.2   

Sources:

1 Pfeifer M et al. Die Wirkungen einer neu entwickelten Rückenorthese auf Körperhaltung, Rumpfmuskelkraft und Lebensqualität bei Frauen mit postmenopausaler Osteoporose. Eine randomisierte Studie. Am J Phys Med Rehabil 2004;83(3):177-186.

2 Pfeifer M et al. Die Wirkungen von zwei neu entwickelten Rückenorthesen auf Rumpfmuskelkraft, Körperhaltung und Lebensqualität bei Frauen mit postmenopausaler Osteoporose. Eine randomisierte Studie. Am J Phys Med Rehabil 2011;90(5):805-815.

Health personnel will make the diagnosis and can prescribe compression stockings, e.g. from medi if necessary.

Your medical retailer will fit them individually for you.