Vertebral Compression Fractures
Pathology: A condition in which the vertebral body of the vertebrae collapses due to compression forces being placed on it (Dutton, 2008).
Demographics: More common in men, seniors, individuals with increased kyphotic posture and decreased bone mineral density as a result of osteoporosis or a tumor in the thoracic spine (Dutton, 2008; Ensrud et al., 1997; AAOS, 2010). Fracture can also occur from trauma in the form of falling from an elevated height, car crash or a sports related injury (AAOS, 2010).
Clinical Presentation: An individual with a compression fracture will present with severe back pain at the fracture site, with the pain worsened by movement (AAOS, 2010;Dutton, 2008). For osteoporotic fractures, the pain may be more subtle with no clinical signs and symptoms and may only be discovered with imaging (Ensrud et al, 1997). If the spinal cord is being compressed, the individual will present with neurological signs below the fracture (Dutton, 2008).
Differential Diagnosis: A thorough patient history to determine the extent of the injury, including history of cancer to assess for possible metastasis, osteoporosis, long-term steroid use, reviewing all red flag and constitutional signs and symptoms to check for systemic illness (Goodman & Snyder, 2007). Examination should also include assessing muscle strength, deep tendon reflexes, sensation and a tap test over the suspected fracture site.
Clinical Bottom Line: This condition is a call for referral if not yet diagnosed. Once the patient receives the appropriate plan of care from their physician, this may include physical therapy for rehabilitation following the fracture and education on posture (Dutton, 2008).
This is an illustration of compressive forces exerted on the vertebral body resulting in a thoracic compression fracture
References
Please refer to the "Vertebral Compression Fractures" section in the references list.