SIGNS AND SYMPTOMS

Mid and/or low back pain associated with a compression fracture may present like arthritis or similar to the aches and pains associated with the degenerative changes attributed to aging. A spinal compression fracture can occur or be present without obvious symptoms, especially if it progresses gradually with the coalescence of smaller stress fractures. Individuals often believe that the sings and/or symptoms they experience are associated with a disc problem, a pinched nerve or muscle strain. Older adults are more likely to develop a compression fracture.

The signs and symptoms of stress fractures include:

• Persistent focal low back discomfort
• Back pain with sudden or chronic onset
• Shortened height
• Development of a hunched back (kyphosis)
• Development of a scoliosis

In severe cases a compression fracture with displacement of bone can narrow the central spinal canal (spinal stenosis) and/or narrow the openings along the side of the spine (neuroforamen). Displaced bone can directly compress the spinal cord and/or spinal nerve roots. A change of the normal spinal curves and segmental relationships such as increased kyphosis and/or scoliosis can also lead to narrowing of the spinal canal. Pressure on the spinal cord from kyphosis and/or displaced bone may produce symptoms of:

•        Pain
•        Numbness
•        Tingling
•        Muscle weakness
•        Bowel and/or bladder dysfunction

The signs and symptoms depend on the area of the back that is affected; however, most fractures do not produce nervous system (neurological) symptoms.

Conditions which may present similar to a spinal compression fracture include:

•           Spinal facet syndrome
•           Degenerative disc disease
•           Intervertebral disc herniation
•           Spinal stenosis
•           Osteomyelitis
•           Spinal tumor
•           Spinal arthritis

CAUSES

Strong and healthy bones are able to withstand the stress and train of normal activity. If forces placed on the spine are too great, a compression fracture might occur. If the bones of the spine are thin and weak stress fractures can develop under pressure leading to a compression fracture.

In a compression fracture of the vertebrae, the bone tissue in the vertebra collapses. More than one vertebra may be affected. Generalized osteoporosis may lead to generalized weakness of the vertebral body at multiple levels of the spine. Any condition which leads to the destruction or loss of bone density within one or more vertebral bodies will render it susceptible to compression fracture. A compression fracture may be caused by one of more of the following:

• Osteoporosis (the most common cause)
• Spinal trauma
• Spinal tumor
• Infection within the bone (osteomyelitis)
• Simple movement or sneeze (in the presence of severe thinning of bone)

RISK FACTORS

Risk factors for the development of a spinal compression fracture include any condition which causes or contributes to thinning of bone. Additional risk factors include any form of trauma or loading of the spine that exceeds the spines ability to support the load or withstand the stress. Conditions associated with thinning of bone include; 

• Osteoporosis
• Overactive parathyroid gland (hyperparathyroidism)
• Certain cancers of the kidney or skin can cause hyperparathyroidism