From the Guidelines
You should consult a specialist, specifically an orthopedic specialist or spine specialist, for vertebral compression fractures of indeterminate age, as they can properly evaluate your condition and develop an appropriate treatment plan. This is based on the most recent and highest quality study, which emphasizes the importance of thorough medical management and appropriate specialist consultation for patients with vertebral compression fractures 1. The specialist will likely order additional imaging such as MRI or bone density tests to assess bone health and determine if the fractures are related to osteoporosis.
Some key points to consider in the management of vertebral compression fractures include:
- Pain management using medications such as acetaminophen, NSAIDs like ibuprofen (600-800mg three times daily), or in some cases, prescription pain medications for short-term use
- Temporary support and stability with a back brace while healing occurs
- Physical therapy to strengthen core and back muscles, improve posture, and prevent future fractures
- Assessment of bone health and determination of the presence of osteoporosis, which may require medications like bisphosphonates (alendronate 70mg weekly) to strengthen bones and prevent additional fractures
It is essential to consult a specialist because compression fractures can sometimes indicate underlying conditions like osteoporosis, cancer, or other serious health issues that require specific treatment approaches 1. The specialist can evaluate the patient's condition, determine the age and severity of the fractures, and develop an appropriate treatment plan to improve quality of life, increase the expectancy of an independent and productive life, and prevent superimposed medical complications 1.
From the Research
Vertebral Compression Fractures of Indeterminate Age
- Vertebral compression fractures can occur due to various reasons such as secondary trauma, malignancies, or most commonly osteoporosis 2.
- The management of vertebral compression fractures involves a multimodal approach, starting with conservative therapy consisting of analgesic medication, medication for osteoporosis, physical therapy, and bracing 3.
- Patients who are refractory to conservative management may be candidates for vertebral augmentation through either vertebroplasty or kyphoplasty 3, 4.
- Initial treatment includes bed rest, pain management with local and systemic analgesia, bracing to improve comfort, and patient reassurance 5.
- Long-term management includes spinal stretching exercises, walking, and treatment of underlying osteoporosis with calcitonin or estrogen in selected patients 5.
Consulting a Specialist
- It is essential to consult a specialist for vertebral compression fractures, especially if the fracture is of indeterminate age, to determine the best course of treatment 2, 3, 4, 6.
- A thorough differential diagnosis should be considered before attributing fractures to osteoporosis, and appropriate evaluation and medical treatment of underlying osteoporosis should be recommended or instituted 6.
- The role of surgical treatment remains controversial and should be reserved for patients who fail initial nonsurgical management options 6.