- Vertebral fracture is usually a pathological fracture due to osteoporosis.
- Diagnosis
- 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