Vertebral Compression Fractures

Abstract

Vertebral compression fractures are very common, and knowledge about the etiology and treatment of compression fractures is essential for physicians. Compression fractures may result from osteoporosis, tumors, and trauma. The treatment of most compression fractures is nonsurgical, and nonsurgical care typically incorporates physical therapy, bracing, and oral medications. Surgical intervention is necessary in cases of intractable pain, instability, and neurologic compromise, however. Another important aspect of treatment is the prevention of future fractures. Patients with osteoporosis should be identified, and prophylactic treatment should be instituted. In the past, calcium, vitamin D, and diphosphonates were the mainstays of osteoporosis treatment. Teriparatide is a relatively new medication that is being used more frequently in patients with osteoporosis. The surgical treatment of osteoporotic compression fractures using vertebral augmentation recently has become controversial. It is important to review the recent literature on the evaluation and treatment of patients with osteoporotic compression fractures and on the surgical treatment of osteoporotic compression fractures with vertebral augmentation.

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