This mechanism usually involves the first column (anterior longitudinal ligament and anterior half of the vertebral body). Presentation and Complications From Vertebral Compression FracturesĬompression fractures of the thoracolumbar spine have a flexion compression mechanism of injury. 19–21 The relative risk for developing VCFs also increases with decreased bone mineral density: if bone mineral density is decreased by 2 standard deviations, the risk of developing a VCF increases by 4 to 6 times. 18 Other studies have also found that having 1 compression fracture increases the risk of another compression fracture by 5 fold, and having 2 or more compression fractures increases the risk of having another fracture by 12 fold. Lindsay et al reported that, irrespective of bone density, having 1 or more VCFs leads to a 5-fold increase in the patient's risk of developing another vertebral fracture. Studies have suggested that having 1 VCF increases the risk of future VCFs. It is estimated that approximately 44 million Americans have osteoporosis and that an additional 34 million Americans have low bone mass. 15, 16 This structural deterioration of the tissue leads to fragile bones that are prone to fractures. Decreased bone mineral density because osteoporosis disrupts the bone microarchitecture and alters the contents of noncollagenous proteins in the bone matrix. 13, 14 Postmenopausal women have the greatest risk because of hormonal changes that can lead to osteoporotic bone. The most common etiology of VCFs is osteoporosis, although trauma, 12 infection, and neoplasm can also lead to VCFs. 10, 11Įtiology of Vertebral Compression Fractures of the Spine 8, 9 VCFs also significantly increase medical costs: the estimated annual cost of VCFs in the US is $746 million. 5, 7, 8 The progressive decline in health status likely contributes to increased morbidity and mortality in patients with VCF compared to the general population. Multiple adjacent VCFs can lead to progressive kyphosis of the thoracic spine, resulting in a number of comorbidities, such as decreased appetite resulting in poor nutrition and decreased pulmonary function. Chronic back pain, which is associated with these kinds of fractures, leads to functional limitations and significant disability. 4–6 Vertebral compression fractures are as common in Asian women as in Caucasian women, and less common in African-American women.Īlthough less severe than hip fractures, VCFs can cause severe physical limitations. However, their risk is markedly less than that of women of the same age. 4 Men older than age 65 years are also at increased risk of compression fractures. 3 Population studies have shown that the annual incidence of VCFs is 10. 2 The prevalence of this condition increases with age, reaching 40% by age 80. 1 Approximately 25% of all postmenopausal women in the US get a compression fracture during their lifetime. Vertebral compression fractures (VCFs) of the thoracolumbar spine are common in the elderly, with approximately 1.5 million VCFs annually in the general US population.
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