A compression fracture occurs when one or more vertebrae in the spine collapse or crack under pressure. They most commonly affect the thoracic and lumbar regions and are a leading cause of back pain, height loss, and spinal deformity in older adults.
Compression fractures are closely associated with other spinal conditions — the resulting vertebral collapse and altered mechanics frequently contribute to Spinal Stenosis and Spondylolisthesis over time. In patients with osteoporosis or cancer, compression fractures can also accelerate Degenerative Disc Disease at adjacent levels.
Causes
Osteoporosis.
The most common cause of vertebral compression fractures is osteoporosis, a condition in which bones become weak and porous. In severe cases, even everyday activities such as sneezing, bending forward, or lifting a light object can cause a fracture.
Other causes
Trauma from falls, car accidents, or sports injuries can cause compression fractures in otherwise healthy bone. Cancer that has spread (metastasized) to the spine can also weaken vertebrae and lead to pathologic fractures.
Symptoms
Symptoms include sudden onset of back pain that worsens with standing or walking and improves with rest. Patients may also notice a gradual loss of height, a stooped posture (kyphosis), and in severe cases, nerve compression leading to numbness, tingling, or weakness in the limbs.
Diagnosis
A physical examination assesses posture, tenderness along the spine, and neurological function. X-rays are typically the first imaging study obtained and can reveal vertebral height loss.
Lumbar spine MRI is used to assess the acuity of the fracture, evaluate the spinal cord and nerve roots, and rule out underlying pathology such as cancer. A bone density scan (DEXA) may be ordered to evaluate for osteoporosis.
Fracture Classification
Compression fractures are classified based on the degree of vertebral collapse and structural stability.
- Grade 1 (Mild): 20–25% loss of vertebral body height.
- Grade 2 (Moderate): 25–40% loss of vertebral body height.
- Grade 3 (Severe): Greater than 40% loss of vertebral body height.
Treatments
Treatment depends on the severity of the fracture, the presence of neurological symptoms, and the patient's overall health and bone quality.
Initial management typically includes rest, pain medications, and bracing to limit spinal movement and allow healing. Addressing underlying osteoporosis with calcium, vitamin D, and bone-strengthening medications is an important part of long-term management.
Conservative treatment: Pain management with analgesics or anti-inflammatory medications, activity modification, and a back brace can help stabilize the spine during healing. Physical therapy is introduced as pain allows to rebuild strength and improve posture.
Minimally invasive procedures
For fractures that do not respond to conservative care, minimally invasive procedures such as vertebroplasty or kyphoplasty may be recommended. These procedures involve injecting bone cement into the fractured vertebra to stabilize it and relieve pain. Kyphoplasty also uses a balloon to restore vertebral height before cement is placed.
Surgical treatment
In cases where the fracture causes significant spinal instability or neurological compromise, open surgery may be required to decompress the spinal cord and stabilize the spine with rods and screws.
Related Spine Conditions
- Spinal Stenosis
- Spondylolisthesis
- Degenerative Disc Disease
- Disc Herniation
- Spinal Tumors
- Back to all Spine Conditions
Get an MRI to Confirm Your Diagnosis
Before surgical planning or starting treatment, a clear MRI diagnosis ensures the right path forward. First Look MRI offers self-pay Lumbar Spine MRI scans — no doctor's order or insurance required — at our locations in Georgia, Texas, and Colorado.