Spinal Fractures: Commonly Asked Questions

My doctor recently diagnosed me as having osteoporosis. What should I be doing now to prevent fractures in the future?
There are several things you can do to help keep your bones healthy and thus prevent future fractures. First, make sure you are building strong bones by getting enough calcium every day, either in the food you eat or in supplemental form. You need between 1,000 mg and 1,200 mg daily. In addition, you need 400 IU to 800 IU daily of vitamin D to help your body absorb the calcium. Weight-bearing exercise (such as walking, hiking, jogging, stair climbing, dancing and soccer) as well as resistance exercise (weight training) will help build bone mass and density. Ask your health care professional if you need to take one of the osteoporosis medications that have been found helpful in keeping bones strong. You may be prescribed a bisphosphonate, selective estrogen receptor modulator, calcitonin or parathyroid hormone. In short, getting a bone density test can help determine how strong your bones are and your risk of future fractures.

Could I have a spinal fracture? What are some of the symptoms?
It is not always easy to tell if you have a spinal fracture because you may think your symptoms are related to a pulled muscle, soft tissue injury or even arthritis. Contact your health care professional right away if you experience sudden back pain (that can last for weeks or months), or notice that you look a bit shorter or have developed stooped posture. A spinal fracture can result from a movement as common as opening a window or twisting your back while lifting an object. Because vertebral bone collapses into itself in a spinal compression fracture, you actually become shorter over time, signaling that multiple spinal fractures have occurred.

If I am diagnosed with a spinal fracture, what treatment options are available to me?
There are several treatment options for osteoporosis-related spinal fractures. Your health care professional will determine the severity of the fracture and the appropriate management plan. Usually, this includes controlling the pain, rest, treating the underlying disease, e.g., osteoporosis, and trying to keep your bones healthy in order to prevent future fractures. A procedure known as balloon kyphoplasty may be recommended to stabilize and repair your spinal fracture. In this minimally invasive procedure, a small orthopaedic balloon is guided into the vertebra. The balloon is carefully inflated in an attempt to raise the collapsed portion of the vertebra and return it to its normal position. Once the vertebra is in the correct position, the balloon is deflated and removed. This process creates a cavity that is then filled with bone cement which hardens to form an internal cast. Another procedure used to relieve pain that can accompany vertebral compression fractures is vertebroplasty. Whereas kyphoplasty attempts to restore normal anatomy of the vertebra, vertebroplasty does not.

What causes a dowager's hump? What is kyphosis?
Kyphosis is the forward curvature of the spine that can result from multiple spinal fractures. In this situation, the front part of your vertebra is compressed but the back of the bone remains intact. Over time, the spine leans/tilts forward. This condition causes the hump-backed, stooped appearance known as a dowager's hump. Not only does your upper spine curve forward, but the lower spine pushes forward against the stomach and surrounding organs, and your abdomen may protrude. If your spine curves enough, you are forced to face downward, and your natural tendency is to correct this posture by bending your knees and tilting your pelvis, putting strain on your muscles and ligaments. In addition, there may be pressure on the spinal cord, which can cause numbness and weakness. Kyphosis can compress the organs in your chest cavity and stomach, causing additional problems such as difficulty moving, decreased appetite, sleep and breathing problems and generalized lower quality of life.

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