Pathophysiology
Vertebral compression fractures typically result from bone that has been weakened, which may be due to:
- Osteoporosis (by far the most common cause)
- Trauma
- Tumors (such as metastases, multiple myeloma, hemangioma)
For those over age 50, the vast majority of vertebral compression fractures are due to osteoporosis. With osteoporosis-related fractures, the osteoclastic activity has exceeded osteblastic activity, diminishing bone density. The bone is softened to the point where any increase in the axial load can result in vertebral fractures.
Vertebral compression fractures characteristically demonstrate a wedge-shaped pattern with collapse of the vertebra anteriorly and vertebral height preservation posteriorly.
Following the initial vertebral compression fracture, the essential biomechanics of the spine are changed, placing additional stress on the adjacent vertebrae and predisposing the patient to additional fractures. Once such a fracture has occurred, the risk of additional fractures in adjacent vertebrae increases 5-fold.
Vertebral compression fractures are potentially serious afflictions that that can lead to kyphosis deformity, poor posture, and create debilitating pain due to nerve pressure. While rare, vertebral fractures can lead to spinal infections and sometimes result in osteomyelitis.
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