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Spinal Compression Fractures

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Diagnosing and Treating Spinal Compression Fractures

Most people with back pain consult their primary health care provider first. The doctor will begin with a thorough medical history and physical exam. If a doctor believes a spinal compression fracture may be present, the following tests may be ordered:

X-rays are usually the first tests ordered; they can show which bones have fractured.

Computerized tomography (CT) is a noninvasive procedure that uses X-rays to produce a three-dimensional image of the spine.  A CT shows more detail than an X-ray, and can identify the bones in greater detail, and show the nerves, spinal cord,and any possible damage to them.

Magnetic resonance imaging (MRI) uses magnetic fields and radio-frequency waves to create an image of the spine, and can reveal fine details of the spine, including nerves, clearer bone detail, tumors, and unstable areas. An MRI scan can show details in the spine that can’t normally be seen on an X-ray. Sometimes a contrast agent is injected into a vein in the hand or arm during the test, which highlights certain tissues and structures to make details even clearer.

Treatment Options

Medical Therapy: Many patients recover very well with medical therapy that consists of:

  • Reduced activity and progressive ambulation
  • Non-steroidal medications to manage pain (although these medications do nothing to heal the fracture.)
  • Prescription medications for pain (opioids)
  • Bracing to stabilize the spine and reduce pain
  • Physical therapy to strengthen the core muscles surrounding the spine and encourage newer, pain-free ways of moving.

Surgical Treatment: Today's surgical treatment options include minimally invasive lumbar fusion or vertebroplasty/kyphoplasty. Surgery may be recommended for patients in severe pain or patients with no significant improvement after a trial of medical therapy.

Open surgery is rarely required for spinal compression fractures and is usually reserved for patients with severe traumatic injury or large tumors.

See Surgery for Spinal Compression Fractures for more details about these surgical procedures.

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Reviewed by Athos Patsalides, M.D.
Last reviewed/last updated: July 2018