Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-28T20:31:14.389Z Has data issue: false hasContentIssue false

Chapter 16 - Vertebral Compression Fractures

from Part IV - Spine

Published online by Cambridge University Press:  01 December 2023

By
Karina Charipova ,
Alan D. Kaye  and
Kyle Gress
Edited by
Omar Viswanath  and
Ivan Urits
Omar Viswanath
Affiliation:
Creighton University, Omaha
Ivan Urits
Affiliation:
Southcoast Brain & Spine Center, Wareham
Get access

Summary

Vertebral compression fractures are characterized by a break in the vertebrae comprising the spinal column, most likely on the anterior side and most commonly occurring when the osseous matrix has been weakened. The high morbidity and mortality associated with VCFs have given rise to an estimated annual medical cost of $13.8 billion in the United States alone. Prevention includes screening at-risk individuals’ bone marrow density and augmenting individuals with decreased bone density with bisphosphonates or RANK ligand inhibitors. The management of VCFs has been heavily debated with arguments for both conservative management and invasive augmentation through vertebroplasty and kyphoplasty. Invasive management should be considered in patients with uncontrolled pain, significant vertebral misalignment, and height deformities.

Keywords

osteopeniaosteoporosisvertebral compression fracturekyphoplastyvertebroplasty
Type
Chapter
Information
Cambridge Handbook of Pain Medicine , pp. 107 - 118
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Donnally, II C, Varacallo, M. Vertebral compression fractures. J Community Nurs. 2018;25(6):39–42.Google Scholar
Montagu, A, Speirs, A, Baldock, J, Corbett, J, Gosney, M. A review of vertebroplasty for osteoporotic and malignant vertebral compression fractures. Age Ageing. 2012;41(4):450–455.CrossRefGoogle ScholarPubMed
Alexandru, D, So, W. Evaluation and management of vertebral compression fractures. Perm J. 2012;16(4):46–51.CrossRefGoogle ScholarPubMed
Beall, D, Lorio, MP, Yun, BM et al. Review of vertebral augmentation: An updated meta-analysis of the effectiveness. Int J Spine Surg. 2018;12(3):295–321.CrossRefGoogle ScholarPubMed
Babayev, M, Lachmann, E, Nagler, W. The controversy surrounding sacral insufficiency fractures: To ambulate or not to ambulate? Am J Phys Med Rehabil. 2000;79(4):404–409.CrossRefGoogle ScholarPubMed
Lau, E, Ong, K, Kurtz, S, Schmier, J, Edidin, A. Mortality following the diagnosis of a vertebral compression fracture in the Medicare population. J Bone Joint Surg Am. 2008;90(7):1479–1486.CrossRefGoogle ScholarPubMed
Cauley, JA, Thompson, DE, Ensrud, KC, Scott, JC, Black, D. Risk of mortality following clinical fractures. Osteoporos Int. 2000;11(7):556–561.CrossRefGoogle ScholarPubMed
Chen, AT, Cohen, DB, Skolasky, RL. Impact of nonoperative treatment, vertebroplasty, and kyphoplasty on survival and morbidity after vertebral compression fracture in the Medicare population. J Bone Joint Surg Am. 2013;95(19):1729–1736.CrossRefGoogle ScholarPubMed
Edidin, AA, Ong, KL, Lau, E, Kurtz, SM. Mortality risk for operated and nonoperated vertebral fracture patients in the Medicare population. J Bone Miner Res. 2011;26(7):617–626.CrossRefGoogle ScholarPubMed
Lange, A, Kasperk, C, Alvares, L, Sauermann, S, Braun, S. Survival and cost comparison of kyphoplasty and percutaneous vertebroplasty using German claims data. Spine (Phila Pa 1976). 2014;39(4):318–326.CrossRefGoogle ScholarPubMed
Edidin, AA, Ong, KL, Lau, E, Kurtz, SM. Morbidity and mortality after vertebral fractures: Comparison of vertebral augmentation and nonoperative management in the Medicare population. Spine (Phila Pa 1976). 2015;40(15):1228–1241.CrossRefGoogle ScholarPubMed
Clerk-Lamalice, O, Beall, DP, Ong, K, Lorio, MP. ISASS policy 2018 –Vertebral augmentation: Coverage indications, limitations, and/or medical necessity. Int J Spine Surg. 2019;13(1):1–10.CrossRefGoogle ScholarPubMed
Mattie, R, Laimi, K, Yu, S, Saltychev, M. Comparing percutaneous vertebroplasty and conservative therapy for treating osteoporotic compression fractures in the thoracic and lumbar spine: A systematic review and meta-analysis. J Bone Joint Surg Am. 2016;98(12):1041–1051.CrossRefGoogle ScholarPubMed
Xiao, H, Yang, J, Feng, X et al. Comparing complications of vertebroplasty and kyphoplasty for treating osteoporotic vertebral compression fractures: A meta-analysis of the randomized and non-randomized controlled studies. Eur J Orthop Surg Traumatol. 2015;25(Suppl 1):S77–S85.CrossRefGoogle ScholarPubMed
Zhang, H, Xu, C, Zhang, T, Gao, Z, Zhang, T. Does percutaneous vertebroplasty or balloon kyphoplasty for osteoporotic vertebral compression fractures increase the incidence of new vertebral fractures? A meta-analysis. Pain Physician 2017;20(1):E13–E28.CrossRefGoogle ScholarPubMed
Jensen, ME, McGraw, JK, Cardella, JF, Hirsch, JA. Position statement on percutaneous vertebral augmentation: A consensus statement developed by the American Society of Interventional and Therapeutic Neuroradiology, Society of Interventional Radiology, American Association of Neurological Surgeons/Congress of Neurological Surgeons, and American Society of Spine Radiology. J Neurointerv Surg. 2009;1(2):181–185.CrossRefGoogle Scholar
Buchbinder, R, Osborne, RH, Ebeling, PR et al. A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med. 2009;361(6):557–568.CrossRefGoogle ScholarPubMed
Kallmes, DF, Comstock, BA, Heagerty, PJ et al. A randomized trial of vertebroplasty for osteoporotic spinal fractures. N Engl J Med. 2009;361(6):569–579.CrossRefGoogle ScholarPubMed
Manchikanti, L, Helm, S, Benyamin, RM, Hirsch, JA. A critical analysis of Obamacare: Affordable care or insurance for many and coverage for few? Pain Physician. 2017;20(3):111–138.CrossRefGoogle ScholarPubMed
Obama, B. United States health care reform: Progress to date and next steps. JAMA. 2016; 316:525–532.CrossRefGoogle ScholarPubMed
Manchikanti, L, Helm, II S, Calodney, AK, Hirsch, JA. Merit-based incentive payment system: Meaningful changes in the final rule brings cautious optimism. Pain Physician. 2017;20(1):E1–E12.CrossRefGoogle ScholarPubMed
Medicare Administrative Contractor Multijurisdictional Contractor Advisory Committee (CAC) meeting re Vertebral Augmentation. March 20, 2019. www.ngsmedicare.com/sv/contractor-advisory-committee-cac?lob=93617%26state=97256%26rgion=93623%26selectedArticleId=446297Google Scholar
Beall, DP, Chambers, MR, Thomas, S et al. Prospective and multicenter evaluation of outcomes for quality of life and activities of daily living for balloon kyphoplasty in the treatment of vertebral compression fractures: The EVOLVE trial. Neurosurg. 2019;84(1):169–178.CrossRefGoogle ScholarPubMed
National Institute for Health and Care Excellence. Percutaneous vertebroplasty and percutaneous balloon kyphoplasty for treating osteoporotic vertebral compression fractures. April 24, 2013. www.nice.org.uk/guidance/ta279.Google Scholar
Ong, KL, Beall, DP, Frohbergh, M, Lau, E, Hirsch, JA. Were VCF patients at higher risk of mortality following the 2009 publication of the vertebroplasty “sham” trials? Osteoporos Int. 2018;29(2):375–383.CrossRefGoogle ScholarPubMed
Johnell, O, Kanis, JA, Odén, A et al. Mortality after osteoporotic fractures. Osteoporos Int. 2004;15(3):38–42.CrossRefGoogle ScholarPubMed
Hirsch, JA, Beall, DP, Chambers, MR et al. Management of vertebral fragility fractures: A clinical care pathway developed by a multispecialty panel using the RAND/UCLA Appropriateness Method. Spine J. 2018;18(11):2152–2161. doi: 10.1016/j.spinee.2018.07.025.CrossRefGoogle Scholar
Marcia, S, Muto, M, Hirsch, JA et al. What is the role of vertebral augmentation for osteoporotic fractures? A review of the recent literature. Neuroradiol. 2018;60(8):777–783.CrossRefGoogle ScholarPubMed
Chandra, RV, Maingard, J, Asadi, H et al. Vertebroplasty and kyphoplasty for osteoporotic vertebral fractures: What are the latest data? AJNR Am J Neuroradiol. 2018;39(5):798–806.CrossRefGoogle ScholarPubMed
Barr, JD, Jensen, ME, Hirsch, JA et al. Position statement on percutaneous vertebral augmentation: A consensus statement developed by the Society of Interventional Radiology (SIR), American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS), American College of Radiology (ACR), American Society of Neuroradiology (ASNR), American Society of Spine Radiology (ASSR), Canadian Interventional Radiology Association (CIRA), and the Society of NeuroInterventional Surgery (SNIS). J Vasc Interv Radiol. 2014;25(2):171–181.CrossRefGoogle Scholar
Wong, CC, McGirt, MJ. Vertebral compression fractures: A review of current management and multimodal therapy. J Multidiscip Healthc. 2013;6:205–214.Google ScholarPubMed
Thibault, I, Whyne, CM, Zhou, S et al. Volume of lytic vertebral body metastatic disease quantified using computed tomography-based image segmentation predicts fracture risk after spine stereotactic body radiation therapy. Int J Radiat Oncol. 2017;97(1):75–81.CrossRefGoogle ScholarPubMed
Hussain, A, Yong, C, Tkaczuk, KHR et al. Prevalence and risk of skeletal complications and use of radiation therapy in elderly women diagnosed with metastatic breast cancer. PLoS One. 2018;13(3):e0193661.CrossRefGoogle ScholarPubMed
Jawad, MS, Fahim, DK, Gerszten, PC et al. Vertebral compression fractures after stereotactic body radiation therapy: A large, multi-institutional, multinational evaluation. J Neurosurg Spine. 2016;24(6):928–936.CrossRefGoogle ScholarPubMed
Boyce-Fappiano, D, Elibe, E, Schultz, L et al. Analysis of the factors contributing to vertebral compression fractures after spine stereotactic radiosurgery. Int J Radiat Oncol. 2017;97(2):236–245.CrossRefGoogle ScholarPubMed
Matsumoto, Y, Shinoto, M, Endo, M et al. Evaluation of risk factors for vertebral compression fracture after carbon-ion radiotherapy for primary spinal and paraspinal sarcoma. Biomed Res Int. 2017;2017:9467402.CrossRefGoogle ScholarPubMed
Otani, K, Teshima, T, Ito, Y et al. Risk factors for vertebral compression fractures in preoperative chemoradiotherapy with gemcitabine for pancreatic cancer. Radiother Oncol. 2016;118(3):424–429.CrossRefGoogle ScholarPubMed
Yun, KY, Han, SE, Kim, SC, Joo, JK, Lee, KS. Pregnancy-related osteoporosis and spinal fractures. Obstet Gynecol Sci. 2017;60(1):133.CrossRefGoogle ScholarPubMed
Krishnakumar, R, Kumar, A, Kuzhimattam, M. Spinal compression fractures due to pregnancy-associated osteoporosis. J Craniovertebr Junction Spine. 2016;7(4):224.CrossRefGoogle ScholarPubMed
Zhang, Y-L, Shi, L-T, Tang, P-F, Sun, Z-J, Wang, Y-H. Correlation analysis of osteoporotic vertebral compression fractures and spinal sagittal imbalance. Orthopade. 2017;46(3):249–255.CrossRefGoogle ScholarPubMed
Takahara, K, Kamimura, M, Moriya, H et al. Risk factors of adjacent vertebral collapse after percutaneous vertebroplasty for osteoporotic vertebral fracture in postmenopausal women. BMC Musculoskelet Disord. 2016;17(1):12.CrossRefGoogle ScholarPubMed
Deibert, CP, Gandhoke, GS, Paschel, EE, Gerszten, PC. A longitudinal cohort investigation of the development of symptomatic adjacent level compression fractures following balloon-assisted kyphoplasty in a series of 726 patients. Pain Physician. 2016;19(8):E1167–1172.Google Scholar
Miller, PD. Clinical management of vertebral compression fractures. J Clin Densitom. 2016;19(1):97–101.CrossRefGoogle ScholarPubMed
Langdon, J, Way, A, Heaton, S, Bernard, J, Molloy, S. Vertebral compression fractures – new clinical signs to aid diagnosis. Ann R Coll Surg Engl. 2010;92(2):163–166.CrossRefGoogle ScholarPubMed
Wu, X, Feng, J, Cao, X et al. Atypical immunoglobulin light chain amyloidosis. Medicine (Baltimore). 2016;95(36):e4603.CrossRefGoogle ScholarPubMed
Pagdal, SS, Nadkarni, S, Hardikar, SM, Hardikar, MS. Role of transpedicular percutaneous vertebral biopsy for diagnosis of pathology in vertebral compression fractures. Asian Spine J. 2016;10(5):925.CrossRefGoogle ScholarPubMed
Nguyen, HS, Soliman, HM, Patel, M et al. CT Hounsfield units as a predictor for the worsening of traumatic vertebral compression fractures. World Neurosurg. 2016;93:50–54.CrossRefGoogle ScholarPubMed
Muratore, M, Ferrera, A, Masse, A, Bistolfi, A. Osteoporotic vertebral fractures: predictive factors for conservative treatment failure: A systematic review. Eur Spine J. 2018;27(10):2565–2576.CrossRefGoogle ScholarPubMed
Ameis, A, Randhawa, K, Yu, H et al. The Global Spine Care Initiative: a review of reviews and recommendations for the non-invasive management of acute osteoporotic vertebral compression fracture pain in low- and middle-income communities. Eur Spine J. 2018;27(S6):861–869.CrossRefGoogle Scholar
Manchikanti, L, Kaye, AM, Knezevic, NN et al. Responsible, safe, and effective prescription of opioids for chronic non-cancer pain: American society of interventional pain physicians (ASIPP) guidelines. Pain Physician. 2017: 20(2S):S3–S92.CrossRefGoogle ScholarPubMed
Manchikanti, L, Sanapati, J, Benyamin, RM et al. Reframing the prevention strategies of the opioid crisis: Focusing on prescription opioids, fentanyl, and heroin epidemic. Pain Physician. 2018;21(4):309–326.CrossRefGoogle ScholarPubMed
Kaye, AD, Jones, MR, Kaye, AM et al. Prescription opioid abuse in chronic pain: An updated review of opioid abuse predictors and strategies to curb opioid abuse: Part 2. Pain Physician. 2017;20(2S):S111–S133.Google ScholarPubMed
Kaye, AD, Jones, MR, Kaye, AM et al. Prescription opioid abuse in chronic pain: An updated review of opioid abuse predictors and strategies to curb opioid abuse: Part 1. Pain Physician. 2017;20(2S):S93–S109.CrossRefGoogle ScholarPubMed
Chakravarthy, K, Manchikanti, L, Kaye, AD, Christo, PJ. Reframing the role of neuromodulation therapy in the chronic pain treatment paradigm. Pain Physician. 2018;21(6):507–513.Google ScholarPubMed
Manchikanti, L, Pampati, V, Benyamin, RM, Hirsch, JA. Cost calculation methodology exacerbates site-of-service differentials by 10- to 18-fold for soft tissue and joint injections in hospital outpatient departments. IPM Reports. 2017;1(6):183–189.Google Scholar
Manchikanti, L, Soin, A, Mann, DP et al. Reversal of growth of utilization of interventional techniques in managing chronic pain in Medicare population post Affordable Care Act. Pain Physician. 2017;20(7):551–567.CrossRefGoogle ScholarPubMed
Manchikanti, L, Soin, A, Mann, DP et al. Comparative analysis of utilization of epidural procedures in managing chronic pain in the Medicare population: Pre and post Affordable Care Act. Spine (Phila Pa 1976). 2019;44(3):220–232.CrossRefGoogle ScholarPubMed
Manchikanti, MV, Manchikanti, L, Kaye, AD, Pampati, V, Hirsch, JA. Usage patterns of sacroiliac joint injections – a comparative evaluation of pre and post Affordable Care Act in Medicare population. IPM Reports. 2018;2(5):157–166.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×