Vertebral fracture

From greek.doctor
  • Vertebral fracture is usually a pathological fracture due to osteoporosis.
  • Diagnosis
    • X-ray
  • Clinical features
    • Loss of height
    • Local pain on percussion
    • Progressive kyphosis
  • Stable fractures
    • Most osteoporotic vertebral fractures are stable
    • Most develop slowly over time and are therefore asymptomatic
    • The structural stability of the spine remains intact
    • No neurological problems
    • Treated conservatively
      • Anti-osteoporotic medication
      • NSAIDs or calcitonin nasal spray
      • Physical therapy
      • External bracing or orthotics
    • If pain remains despite conservative treatment -> vertebral augmentation
  • Unstable fractures
    • Osteoporotic vertebral fractures are rarely unstable
      • Unstable fractures are most commonly traumatic in origin
    • The structural stability of the spine is compromised
      • This may cause spinal cord injury and neurological problems
    • Unstable fractures must be treated urgently to prevent permanent neurological injury
    • Treated surgically
      • Mostly with vertebral augmentation (vertebroplasty or kyphoplasty)
      • Alternative: spinal fusion surgery