OVERVIEW
What are vertebral fractures?
Vertebral fractures — fractures of the bones of the spinal column — occur across a broad spectrum of severity. At one end are stable osteoporotic compression fractures that can often be managed with bracing and pain control, or treated with minimally invasive vertebroplasty or kyphoplasty. At the other end are high-energy traumatic burst fractures that may require urgent surgical stabilization to prevent spinal cord injury.
The most common vertebral fractures in older adults are osteoporotic compression fractures — fractures of the vertebral body caused by the weakened bone of osteoporosis. These often occur with minimal trauma — bending forward, lifting a light object, or even coughing. They are frequently missed and attributed to muscle strain.
Dr. Enguidanos evaluates and treats the full spectrum of vertebral fractures at HCA Florida Twin Cities Hospital and Emerald Coast Surgical Center in Niceville, Florida. He serves patients throughout the Florida Panhandle and Gulf Coast requiring both minimally invasive and open surgical stabilization.
SYMPTOMS
Common symptoms.
- Sudden onset of severe back pain, often at a specific vertebral level
- Pain that is worse with movement — standing, sitting, rolling over
- Tenderness directly over the fractured vertebra
- Progressive kyphosis — forward rounding of the spine with multiple fractures
- Loss of height over time from multiple compression fractures
- Neurological symptoms — weakness, numbness, bowel or bladder changes — in unstable fractures
- Rib pain from the rib cage compressing the abdomen as height is lost
- History of osteoporosis, cancer, or high-energy trauma
CAUSES AND RISK FACTORS
What causes it.
- Osteoporosis — the most common cause in adults over 60
- High-energy trauma — motor vehicle accidents, falls from height
- Pathological fractures — cancer metastases or multiple myeloma weakening the bone
- Stress fractures — repeated loading causing fatigue failure in the pars interarticularis
- Steroid use — long-term corticosteroids cause bone loss and increase fracture risk
- Low-energy trauma in osteoporotic bone — bending, coughing, minor falls
WHEN TO SEEK CARE
When to call us.
Seek urgent evaluation for any suspected vertebral fracture with neurological symptoms — weakness, numbness, bowel or bladder changes. These may represent an unstable fracture threatening the spinal cord and require immediate imaging and surgical evaluation.
For osteoporotic compression fractures without neurological symptoms, seek evaluation when pain is severe, when it is not improving after four to six weeks of conservative management, or when imaging confirms a fracture. Vertebroplasty or kyphoplasty can provide rapid pain relief for acute fractures.
