Compression fracture

Compression fracture
Classification and external resources
Compression fracture of the fourth lumbar vertebra post falling from a height.
ICD-9	or 805x and 806x,if traumatic 733.13 or 805x and 806x,if traumatic

X-ray of the lumbar spine with a compression fracture of the third lumbar vertebra.

A compression fracture is a collapse of a vertebra. It may be due to trauma or due to a weakened vertebra. This weakening is seen patients with osteoporosis or osteogenesis imperfecta, lytic lesions from metastatic or primary tumors,^[1] or infection^[2]. In healthy patients it is most often seen in individuals suffering extreme vertical shocks, such as ejection seats. Seen in lateral views in plain x-ray films, compression fractures of the spine characteristically appear as wedge deformities, with greater loss of height anteriorly than posteriorly and intact pedicles in the anteroposterior view.^[3]

Treatment

Conservative treatment

• Calcitonin^[4]

Surgical

• Kyphoplasty^[5] and vertebroplasty^[5][6], minimally invasive procedures designed to treat pain from osteoporotic compression fractures and sometimes other forms of fracture, such as a fracture caused by certain types of cancer. Vertebroplasty has been found to be ineffective.^[7][8]

References

1. ^ Rounds 2:Treatment of Metastic Bone Disease. A CME approved training from Johns Hopkins Arthritis Center.
2. ^ NIH summary of osteomyelitis for patients
3. ^ Brant W, Helms C. Fundamentals of Diagnostic Radiology. pp. 302. 
4. ^ Knopp JA, Diner BM, Blitz M, Lyritis GP, Rowe BH (2005). "Calcitonin for treating acute pain of osteoporotic vertebral compression fractures: a systematic review of randomized, controlled trials". Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA 16 (10): 1281–90. doi:10.1007/s00198-004-1798-8. PMID 15614441. 
5. ^ ^{a b} Taylor RS, Taylor RJ, Fritzell P (2006). "Balloon kyphoplasty and vertebroplasty for vertebral compression fractures: a comparative systematic review of efficacy and safety". Spine 31 (23): 2747–55. doi:10.1097/01.brs.0000244639.71656.7d. PMID 17077747. 
6. ^ Taylor RS, Fritzell P, Taylor RJ (2007). "Balloon kyphoplasty in the management of vertebral compression fractures: an updated systematic review and meta-analysis". European Spine Journal 16 (8): 1085. doi:10.1007/s00586-007-0308-z. PMC 2200787. PMID 17277923. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2200787. 
7. ^ Kallmes DF, Comstock BA, Heagerty PJ, et al. (August 2009). "A randomized trial of vertebroplasty for osteoporotic spinal fractures". N. Engl. J. Med. 361 (6): 569–79. doi:10.1056/NEJMoa0900563. PMC 2930487. PMID 19657122. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2930487. 
8. ^ Buchbinder R, Osborne RH, Ebeling PR, et al. (August 2009). "A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures". N. Engl. J. Med. 361 (6): 557–68. doi:10.1056/NEJMoa0900429. PMID 19657121. 

External links

• Vertebral Compression Fracture information on eMedicineHealth
• JAMA patient page on osteomyelitis
• Medscape article on lytic lesions
• Emedicine article on spinal metastasis