Vertebral Compression Fractures (VCF)

About VCFs

Vertebral Compression Fractures (VCFs) occur when the bony block or vertebral bone collapses, which can lead to severe pain, deformity and loss of height. It is estimated that more than 900,000 people suffer from VCFs every year. While VCFs are most common in patients suffering from osteoporosis, they also can be caused by trauma to the back or tumors spreading to the spine .

Clinical Symptoms of VCFs

The main clinical symptoms of VCFs may include any of the following, alone or in combination:

  • Sudden onset of back pain
  • An increase of pain intensity while standing or walking
  • A decrease in pain intensity while lying on the back
  • Limited spinal mobility
  • Eventual height loss
  • Eventual deformity and disability

Personal Impact of VCFs

The impact of VCFs on quality of life is significant, resulting in:

  • Loss of self-esteem
  • Development of a distorted body image
  • Depression
  • Decreased activity
  • Increased anxiety
  • Diminished social roles
  • Increased dependence on others

VCFs also are associated with increased morbidity and mortality.  Early, accurate diagnosis and appropriate intervention of VCFs is paramount, due to the number of potential adverse effects.

Diagnosis is Imperative

People who have sustained one osteoporotic VCF are five times more likely to sustain a second VCF, making diagnosis an important part of preventing further damage to the spine. Occasionally a VCF can be present with either minor symptoms or no symptoms, and two-thirds of all VCFs go undiagnosed. This is due to a number of factors, including non-specific pain description, the priority of co-morbidities, a low index of suspicion, and inaccurate X-rays (42 percent of symptomatic fractures do not appear collapsed). In fact, experts suggest that patients report moderate or severe fractures only 50 percent of the time. 

Osteoporosis and VCFs

Osteoporosis is the most common cause of VCFs. According to the National Institutes of Health, osteoporosis is defined as a systemic skeletal disease characterized by compromised bone strength that predisposes the affected bone to fracture.

Osteoporosis-related disability confines patients to more immobile days in bed than stroke, heart attack or breast cancer. VCFs can lead to back pain, loss of height, deformity, immobility, increased number of bed days and even reduced pulmonary function.

An estimated 55 percent of the people over 50 years of age have osteoporosis or are at great risk of getting osteoporosis: 80 percent of those are women. In fact, approximately one in two women over age 50 will have an osteoporosis-related fracture in her remaining lifetime.

Treatment Options

There are a variety of treatment options available for VCFs. It is important that the treatment addresses the pain, the fracture and the underlying medical issue that caused the fracture.

Conservative medical management, also known as non-operative care includes:

  • Pain medications
  • Bed rest
  • Back brace to support spine (also referred to as stabilization)
  • Physical therapy/exercise

Surgery

Invasive back surgery options are generally considered as a last resort. Back surgery options provide pain relief by fusing, or joining together, two vertebrae to eliminate pain-causing motion. Typically, metal screws are inserted into the vertebrae and then attached to metal plates or rods at the back of the spine.

Minimally Invasive Procedures

When conservative treatment options have proven ineffective, a minimally invasive surgical procedure may be considered. as treatment options:

  • Vertebroplasty – used as a spine fracture treatment, vertebroplasty is a procedure in which liquid bone cement is injected into the affected vertebra to stabilize the fracture and relieve pain. Cement leaking from the injection site and/or areas of the vertebra before the fracture is stabilized can be problematic, resulting in nerve irritation and potential embolism, or blood clots.
  • Kyphoplasty – now referred to as vertebral augmentation, involves the creation of a cavity using either a balloon or other instrument prior to delivering cement into the fractured vertebra. Developed in 1998, a conventional balloon kyphoplasty procedure involves first creating a cavity in the affected vertebra by inflating a balloon, pushing bone aside, and then filling it with bone cement. The bone that is crushed by the balloon as it expands may act as a barrier to help contain the cement and in some cases can help minimize leakage.
  • Radiofrequency-Targeted Vertebral Augmentation™ (RF-TVA or RF Kyphoplasty) – the latest advancement in the treatment of VCFs, RF-TVA, offers a predictable and reliable treatment option for patients. By harnessing the power of radiofrequency energy, RF-TVA allows physicians to repair fractured vertebrae through smaller cavities – limiting damage to surrounding healthy bone, and improving cement placement. RF-TVA provides immediate and lasting back pain relief, improvement in mobility and restoration of quality of life. Many patients often return to daily activities soon after the procedure. Patients may go home the same day or the following day.*

Vertebral Augmentation sequence

To Learn More

If you have been diagnosed with vertebral compression fracture, or are interested in learning how about treatment options to manage your pain, please contact our pain management experts at The Spine and Pain Institute of New York in Manhattan, New York and Staten Island, New York. We would be happy to make an appointment for a consultation and provide additional information about other treatment options.

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