Genesis Chiropractic Spine & Sports Center
7940 South University Blvd Suite 100, 
Centennial Co 80109
Phone (303) 927-6181 or (720) 515-8002
Email: GenesisSpineCenter@gmail.com
Genesis Chiropractic Spine & Sports Center      













Osteoporotic Comp Fx T/L

General Information

 

Description:

  • Fracture of vertebra most commonly related to osteoporosis but can be due to trauma, metastatic cancer or hemangioma

Also called:

  • Compression fracture
  • Osteoporotic compression fracture
  • Vertebral compression fracture

Organs involved:

  • Anterior body of vertebrae

Incidence/Prevalence:

  • 1 in 6 elderly had incidental vertebral fracture on chest x-ray done in emergency department in series of 500 patients (Arch Intern Med 2005 Apr 25;165(8):905)

Causes and Risk Factors

Causes:

  • Osteoporosis

Likely risk factors:

  • Existing vertebral fractures associated with new adjacent vertebral fractures

  • Existing vertebral fractures and low bone mineral density (BMD) associated with new vertebral fractures
    • Based on longitudinal cohort study
    • 2,680 white women (out of original 9,704 women recruited) attended follow-up clinic visit mean 14.9 years after baseline
    • 487 (18.2%) women had incident vertebral fracture during follow-up
    • Mean age 68.8 years at entry and 83.8 years at follow-up
    • Incidence of new vertebral fracture was
      • 41.4% (163) of 394 women with existing vertebral fracture at baseline
      • 14.2% (324) of 2,286 women without vertebral fracture at baseline
    • Low BMD associated with increased risk of incident vertebral fracture
    • Absolute risk of vertebral fracture
      • 56% in women with total hip BMD T score ≤ -2.5 and existing vertebral fracture
      • 9% in women with normal BMD and no prior vertebral fracture
    • Reference - JAMA 2007 Dec 19;298(23):2761,
  • In nursing home residents, low bone mineral density and independence with transfers associated with increased risk for osteoporotic fractures
    • Based on 18-month prospective study of 1,427 nursing home residents > 65 years old
    • Reference - JAMA 2000 Aug 23-30;284(8):972, editorial can be found in JAMA 2000 Aug 23-30;284(8):1018
  • Cardiac or liver transplantation may be associated with increased risk for vertebral fracture
    • Based on 235 consecutive patients having cardiac or liver transplantation
    • 21-27% had at least one vertebral fracture within 2 years
    • Reference - Lancet 2001 Feb 3;357(9253):342, editorial can be found in Lancet 2001 Feb 3;357(9253):325  

Possible risk factors:

  • Proton pump inhibitors (PPIs) use associated with increased risk of vertebral fracture compared to non/past PPI users
    • Based on systematic review of 10 studies (4 cohort and 6 case-control) evaluating risk of fracture with PPI use
    • 223,210 fracture cases (primarily hip, spine and wrist) were included in systematic review
    • PPI use associated with increased risk of vertebral fracture (odds ratio 1.5, 95% CI 1.32-1.72) compared to non/past users in analysis of 4 trials
    • Reference - Am J Gastroenterol. 2011 Jul;106(7):1209
  • High prevalence of vertebral fractures in patients with Crohn's disease and osteoporosis
    • Study of 156 patients with Crohn's disease and lumbar osteopenia or osteoporosis
    • 63 vertebral fractures were seen in 34 patients, 1/3 patients were < 30 years old
    • 4 patients had clinically evident fractures with severe back pain
    • Reference - Gut 2002 Nov;51(5):654

 

Complications and Associated Conditions

Complications:

  • Vertebral fractures and non-vertebral fractures associated with lower quality of life
    • Based on study of 2,009 postmenopausal women
    • Reference - BMC Musculoskelet Disord 2002 Apr 22;3:11 
  • Kummel disease (avascular necrosis of vertebral body after vertebral compression fracture) in case report (J Am Board Fam Med 2009 Jan-Feb;22(1):75)

Associated conditions:

  • History of wrist or spine fracture associated with increased risk of hip fracture in men and women
    • Systematic review and meta-analysis of 9 cohort studies with men and women > 50 years old assessing fracture associated with minimal trauma to wrist or spine and risk of subsequent hip fracture
    • Among postmenopausal women, relative risk of hip fracture was 1.53 after wrist fracture and 2.2 after spine fracture
    • Among men, relative risk of hip fracture was 3.26 after wrist fracture and 3.54 after spine fracture
    • Reference - J Bone Joint Surg Am 2003 Oct;85-A(10):1936 in J Musculoskel Med 2004 Mar;21(3):184