Compression fracture
A compression fracture is a collapse of a vertebra. It may be due to trauma or due to a weakened vertebra. This weakening is seen patients with osteoporosis or osteogenesis imperfecta, lytic lesions from metastatic or primary tumors,[1] or infection[2]. In healthy patients it is most often seen in individuals suffering extreme vertical shocks, such as ejection seats. Seen in lateral views in plain x-ray films, compression fractures of the spine characteristically appear as wedge deformities, with greater loss of height anteriorly than posteriorly and intact pedicles in the anteroposterior view.[3]
Treatment
Conservative treatment
Surgical
- Kyphoplasty[5] and vertebroplasty[5][6], minimally invasive procedures designed to treat pain from osteoporotic compression fractures and sometimes other forms of fracture, such as a fracture caused by certain types of cancer. Vertebroplasty has been found to be ineffective.[7][8]
References
- ^ Rounds 2:Treatment of Metastic Bone Disease. A CME approved training from Johns Hopkins Arthritis Center.
- ^ NIH summary of osteomyelitis for patients
- ^ Brant W, Helms C. Fundamentals of Diagnostic Radiology. pp. 302.
- ^ Knopp JA, Diner BM, Blitz M, Lyritis GP, Rowe BH (2005). "Calcitonin for treating acute pain of osteoporotic vertebral compression fractures: a systematic review of randomized, controlled trials". Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA 16 (10): 1281–90. doi:10.1007/s00198-004-1798-8. PMID 15614441.
- ^ a b Taylor RS, Taylor RJ, Fritzell P (2006). "Balloon kyphoplasty and vertebroplasty for vertebral compression fractures: a comparative systematic review of efficacy and safety". Spine 31 (23): 2747–55. doi:10.1097/01.brs.0000244639.71656.7d. PMID 17077747.
- ^ Taylor RS, Fritzell P, Taylor RJ (2007). "Balloon kyphoplasty in the management of vertebral compression fractures: an updated systematic review and meta-analysis". European Spine Journal 16 (8): 1085. doi:10.1007/s00586-007-0308-z. PMC 2200787. PMID 17277923. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2200787.
- ^ Kallmes DF, Comstock BA, Heagerty PJ, et al. (August 2009). "A randomized trial of vertebroplasty for osteoporotic spinal fractures". N. Engl. J. Med. 361 (6): 569–79. doi:10.1056/NEJMoa0900563. PMC 2930487. PMID 19657122. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2930487.
- ^ Buchbinder R, Osborne RH, Ebeling PR, et al. (August 2009). "A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures". N. Engl. J. Med. 361 (6): 557–68. doi:10.1056/NEJMoa0900429. PMID 19657121.
External links
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noco/cong/tumr, sysi/epon, injr
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