Management of Vertebral Compression Fractures Case Presentation A 75 year old caucasian female presents to the emergency department with increasing mid back discomfort.
Management of Vertebral Compression Fractures Case Presentation A 75 year old caucasian female presents to the emergency department with increasing mid back discomfort. She denies any trauma and plain radiographs show a compression fracture at the T10 level. Which of the following is NOT a risk factor for a vertebral compression fracture?
Hormonal dysregulation D. Obesity Vertebral compression fractures (VCFs) can cause severe physical limitations, including back pain, functional disability, and progressive kyphosis of the spine that ultimately results in decreased appetite, poor nutrition, and impaired pulmonary function. Morbidities associated with vertebral compression fractures are substantial and can result in permanent loss of mobility and quality of life and lead to substantial disability.
It is important for sports medicine providers to be comfortable with the management of compression fractures depending on their practice. VCFs are relatively common, with approximately 1.5 million adults affected in the US population annually. The Thoracolumbar junction (T12 to L2) has been reported to be the most frequently affected site with 60% to 75% of VCFs, followed by the L2 to L5 region comprising 30% of VCFs.
VCFs are also the most common sequelae of osteoporosis, another common disease affecting primarily the elderly population. In younger patients, 50% of VCFs are due to motor vehicle collisions with another 25% due to falls. Management of vertebral compression fractures has been extensively discussed with opponents arguing against the augmentation and restricting to conservative management.
Management of vertebral compression fractures ranges from conservative pharmacologic analgesia to more invasive solutions like percutaneous vertebroplasty or percutaneous kyphoplasty. Despite the range of therapies, the heterogeneity of the affected patient population and misinterpretation of evidence has made it difficult to establish appropriate guidance. Conservative Management Current conservative treatment options for management of VCFs include oral analgesics (NSAIDs or opioids), rehabilitative exercise, osteoporosis treatment (calcitonin, bisphosphonates), spinal orthotics, and multimodal therapy.
If you are experiencing symptoms that may be related to management of vertebral compression fractures, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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