Population studies have shown that the annual incidence of VCFs is 10. The number of patients aging and having a diagnosis of osteoporosis is projected to rise. Currently, 10 million Americans are already diagnosed with osteoporosis, and another 34 million have osteopenia. As the population continues to age, the population at risk of sustaining low energy fragility fractures will continue to increase as well. Studies have reported an estimate of 30% of VCFs occurring while the patient is in bed. This is in stark contrast to the elderly mechanism of injury at presentation. In younger patients, about 50% of spine fractures are due to motor vehicle collisions with another 25% being due to falls. Recent reports cite the thoracolumbar junction (i.e., the segment from T12 to L2) as the location afflicted with 60% to 75% of VCFs, and another 30% occur at the L2 to L5 region. Moreover, it is estimated that 40% to 50% of patients over age 80 years have sustained a VCF either acutely or recognized incidentally during clinical workup for a separate condition. Approximately 1- to 1.5 million VCFs occur annually in the United States (US) alone. Based on the age- and sex-adjusted incidence, it is estimated that 25% of women 50 years of age and older have at least one VCF. VCFs are the most common fragility fracture reported in the literature. When the fracture pattern involves the middle column they are classified as burst fractures and lack the stability of a VCF. Thus, VCFs are considered "stable" fracture patterns. If two of these three columns are compromised, the injury is considered unstable, and the patient potentially needs surgery.Ĭompression fractures by definition only involve compromise to the anterior column alone. ĭue to the ligamentous and anatomical changes noted as one travels from the thoracic to the lumbar level, inherent areas of instability make this a frequent site of injury.įor the spinal column, traditional teaching is that the column can be divided into three sections: (1) anterior column (anterior longitudinal ligament, anterior annulus, the anterior portion of the vertebral body, (2) middle column (posterior vertebral body, posterior annulus, and posterior longitudinal ligament), and (3) the posterior column (ligamentum flavum, neural arch, facets, posterior ligamentous complex). However, compression fractures demonstrate a bimodal distribution with younger patients sustaining these injuries secondary to high energy mechanisms (fall from a height, MVA, etc.). The most common etiology of VCFs is osteoporosis, making these fractures the most common fragility fracture. Compression fractures are usually considered stable and do not require surgical instrumentation. The implications of these compression fractures are related to the stability of the resulting structure and potential for deformity progression. The former distinguishes a compression fracture from a burst fracture. VCFs do not involve the posterior half of the VB and do not involve the posterior osseous components or the posterior ligamentous complex (PLC). This leads to the characteristic wedge-shaped deformity. VCFs by definition compromise the anterior column of the spine, thereby resulting in compromise to the anterior half of the vertebral body (VB) and the anterior longitudinal ligament (ALL). Vertebral compression fractures (VCFs) of the spinal column occur secondary to an axial/compressive (and to a lesser extent, flexion) load with resultant biomechanical failure of the bone resulting in a fracture. Explain the importance of improving care coordination among the interprofessional team to enhance the delivery of care for patients with vertebral compression fractures.Describe the typical imaging findings associated with vertebral compression fractures. Review the pathophysiology of vertebral compression fractures.Explain the common physical exam findings associated with vertebral compression fractures.This activity outlines the evaluation and management of vertebral compression fractures and underscores the role of the interprofessional team in improving care for the patients with this condition. Vertebral compression fractures by definition compromise the anterior column of the spine, thereby resulting in compromise to the anterior half of the vertebral body and the anterior longitudinal ligament. Vertebral compression fractures of the spinal column occur secondary to an axial/compressive load with resultant biomechanical failure of the bone, resulting in a fracture.
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