Lumbar Spine Fracture Flashcards
Definition/Description
The definition of a fracture is a complete or partial interruption of the continuity of the bone.[1] Compression fractures are either caused by osteoporosis or trauma. Most of the fractures (60%-75%) occur in the L1 segment, and are often associated with the thoracolumbar region.
The non-traumatic fractures can be caused by osteoporosis (especially in the postmenopausal women), because there is a decrease of the bone mineral density. Those are caused by pressure placed against the vertebrae due to lack of disc cushioning between the spinal bones. Osteoporotic spine fractures can be graded based on vertebral height loss as:
mild: 20-25%
moderate: 25-40%
severe: >40%
Epidemiology / Risk factors
ageing- above at the age of 80 years, 40% of the women have received at least one compression fracture.
Female sex: Postmenopausal middle-aged (55-65) women go through hormonal changes which give them a higher change of developing osteoporosis.
One-fourth of the postmenopausal women will be affected with vertebral compression fractures.
The difference in incidence according to sex is nearly double for women, particularly as they age. In general, 10.7 per 1000 women have a vertebral compression fracture annually in the United States, compared with 5.7 fractures per 1000 men
Certain medications: eg oral steroids, anti-depressants, diabetes drugs.
Tumour cells in the vertebra in 80% of the situations are invaded by tumor cells from the breast or prostate cancer. This cancer metastasis on the vertebrae, is the most common skeletal complication in vertebral compression fractures.
Characteristics/Clinical Presentation
Even though these fractures are most common with osteoporosis, there is also a possibility they are caused by high load impact trauma with a flexion compression mechanism.
Midline back pain is the hallmark symptom of lumbar compression fractures. The pain is axial, nonradiating, aching, or stabbing in quality and may be severe and disabling. The location of the pain corresponds to the fracture site, as seen on radiographs. In elderly patients with severe osteroporosis, however, there may be no pain at all as the fracture occurs spontaneously.
