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Osteoporotic Compression Fracture Symptoms

Spinal fractures from osteoporosis usually cause sudden severe pain in the back which can spread around the sides and the front of the chest or abdomen. This pain can be difficult to control even with very strong painkillers.

Doctor checking a patients blood pressure

What causes osteoporotic compression fractures?

Osteoporosis is most often due to vitamin D deficiency but can be due to more complicated medical conditions such as liver or kidney disease. Compression fractures can also occur in the context of cancer spread to the spine but these can usually be distinguished on an MRI or CT scan.

How is a compression fracture diagnosed?

Whilst compression fractures are usually seen on x rays, they are more accurately assessed on a CT or MRI scan. If treatment, such as vertebroplasty, is planned then CT is essential in establishing suitability. If the age of the fracture is unclear then MRI is very helpful in checking whether the fracture is recent or older.

Do I need treatment?

No. Treatment is indicated if the pain is not controlled well. In some cases, there is also a good reason to avoid the use of opiate painkillers and so treatment is indicated. If pain is minimal and well-controlled then treatment may not be required.

How is a compression fracture managed?

If osteoporotic then you will have to have your bone mineral density assessed. A trial of painkillers is started. If there is an inadequate improvement you may be referred for vertebroplasty.

When you are seen by the IR specialist you can trust that you will be only offered treatment if it is thought to be your best option

Frequently Asked Questions

  • How do I know if I am a candidate?  Open or Close

    Initial patient enquiries are welcome. Send us an email or call and we will email a patient information form for you to complete.

    Ask your GP to refer you for a consult. Note that consultations without a referral cannot be claimed from Medicare.

    After listening to your symptoms and taking a medical history we will discuss further investigations or scans needed to establish whether you are a candidate

  • What investigations or scans are needed?  Open or Close

    This will be discussed at time of consult but may include:

    • CT scan – to assess the full extent of the fracture
    • MRI – to check whether there is any risk of nerve damage from the fracture
    • DEXA – to check for osteoporosis
  • How long is the procedure?  Open or Close
    The treatment takes about 90 mins.
  • Do I need an anaesthetic?  Open or Close
    You will stay in hospital until your pain is improved and your mobility is at a level where you are safe to be discharged. If you are previously well and an outpatient then this may be a short period, for other patients this can take longer.
  • How is the procedure performed? Open or Close

    This is a complex and difficult procedure performed by a specialist interventional radiologist – an expert in this area. A special needle is used to enter the fractured bone through the skin on the back. Once in position, a special bone cement is slowly injected to help restore strength to the broken bone.

  • How long will I be in hospital?  Open or Close
    You will stay in hospital for a few hours afterward, until sedation has fully worn off.
  • What is the recovery period?  Open or Close

    This depends on your baseline function and fitness. We expect some improvement in pain in the first day or so. You can begin mobilising and physio the next day. It is important to prevent muscle and strength loss so rehab is important.

  • Why should I choose pelvic vein embolisation?  Open or Close
     

    Embolisation for PCS is an excellent option if your symptoms are poorly controlled on medication, no other cause has been identified and you have imaging showing pelvic vein incompetence.

  • What is the evidence Vertebroplasty works?  Open or Close
     

    The research into vertebroplasty has shown some conflicting results, with some studies showing that it is no better than placebo. Recent trials however which focus on patients with acute fractures show significant improvement in pain which is more than in those patients who underwent a sham procedure.

  • What are the downsides?  Open or Close

    In some cases, there can be further vertebral fractures. We do not know if this is because of the treatment or whether they would have happened anyway because of the osteoporosis.

    There is also a potential risk of some nerve symptoms if the cement leaks around the nerve roots.

  • Is this treatment for everyone?  Open or Close
    No. Some women will have evidence of pelvic vein incompetence but not have symptoms.
  • In a nutshell:  Open or Close
    An effective method of pain control in well selected patients with spinal osteoporotic compression fractures.

Safe, effective treatments with less pain and quicker recovery.

Ensure you know all your options prior to invasive surgical treatment, schedule a consult with Dr Shaun Quigley.