Spinal Fractures: Frequently Asked Questions

Are spinal fractures difficult to diagnose?
If a spinal fracture, also known as a vertebral compression fracture (VCF), is suspected during a physical exam, diagnosis can be easily confirmed with radiographic studies. Spinal fractures tend to be under-recognized by physicians and patients alike. The difficulty with diagnosis arises when the discomfort from a compression fracture is mistakenly regarded as simple "back pain" or a "normal" part of aging. Sometimes, a person can have a compression fracture and not have any symptoms at all; this too, can be an obstacle to diagnosis.

Fractured vertebral body (side view)

If you have back pain or have noticed a change in your posture (i.e., dowager's hump), it is important to consult with a physician. A physical exam, together with an X-ray and MRI, can help your physician determine if your back pain or postural changes are due to spinal fractures or not.

Why is it important to treat spinal fractures?
After an initial spinal fracture, the risk for having another fracture is increased five-fold. In addition, just one fracture can affect the distribution of weight along the spinal column. Misalignment brought on by a fractured vertebra places more stress on adjacent vertebrae; the front of the spine has to withstand the same amount of stress with fewer functioning parts, resulting in a structure that is now weakened and vulnerable to additional fracture.

What are the symptoms of a spinal fracture?
Most compression fractures have a gradual onset, unrelated to specific injury or trauma. Spinal fractures can occur as a result of normal activity such as bending over to pick something up, reaching toward something, or carrying a bag of groceries. Patients can experience pain ranging from sudden and severe, to persistent and dull. The fact that symptoms of spinal fractures can be easily confused with other less serious back problems underscores the importance of obtaining a correct diagnosis and receiving treatment.

How common are spinal fractures?
In the United States, approximately 150,000 patients are hospitalized every year with compression fractures (average hospital stay 8 days), resulting in costs in excess of $1.6 billion. According to the National Osteoporosis Foundation, the annual direct expenditure (hospitals and nursing homes) for osteoporotic and related fractures has been estimated at $17 billion (2001). This figure translates to $47 million each day, and the cost is rising.

Can spinal fractures adversely affect my overall health?
In cases of multiple fracture, postural changes, i.e., kyphosis, can become more pronounced, painful and debilitating over time. Forward curvature of the spine has a "compression effect" on your organs, making it progressively difficult to breathe, walk, eat or sleep properly. Patients with kyphosis have an estimated 24% increase in mortality compared to patients without compression fractures.

What are the psychosocial effects of compression fractures?
Studies have shown that patients with multiple compression fractures experience depression, anxiety and lowered self-esteem, in addition to medical complications. The alteration in lifestyle that accompanies severe kyphosis can profoundly affect a patients' sense of well-being and cause feelings of isolation and sadness.