The spine contains some of the strongest bones in our body, but even our spines are prone to injury for a number of reasons. Just like all the other bones in the human anatomy, a vertebra in the spine can fracture and, when it does, it will need prompt attention.
A lumbar compression fracture is defined as a vertebral bone in the spine that, due to fracture, has decreased in height by at least 15% to 20%. These fractures tend to occur in the upper back – or thoracic spine – and are quite often the result of osteoporosis. As such, older individuals – often women – are the victims of lumbar compression fractures.
Some lumbar compression fractures are referred to as “wedge” fractures because the front of the vertebra collapses and the back is unchanged, forming a wedge-shaped vertebra. However, individuals can also suffer from a “crush” fracture, which indicates that the entire bone has broken; or a “burst” fracture, which involves loss of height in both the front and back walls of the vertebral body.
So how does someone know they’re suffering from a lumbar compression fracture?
Though there are many conditions that cause similar back pain, a compression fracture is usually characterized by sudden onset pain. Patients achieve some degree of relief when lying on their back but walking and standing is generally painful. Mobility is generally impaired, sometimes to quite an extent, and disability and deformity may eventually occur.
Those who treat the spine know that a lumbar compression fracture is quite often the culprit when a patient arrives with back pain that has seemingly come from nowhere. This is especially true with osteoporosis patients, who are plagued with a condition that’s normally silent, though debilitating. That’s why spine specialists are likely to suspect a compression fracture when patients over the age of 50 come to their office complaining of sudden pain. (Though on rare occasions, pain does not accompany a compression fracture at all.)
When a patient arrives complaining of severe pain that seems unexplainable, they will naturally be anxious to receive a diagnosis. They can probably tell you that the pain happened perhaps after a fall that jarred their spine or maybe after lifting or bending. Sometimes, however, when osteoporosis is really advanced, fractures can occur with relative ease and could be caused by the slightest movement, like turning over in bed or perhaps coughing.
Once you’ve determined that you are indeed dealing with a lumbar compression fracture, which may demand a CT scan or MRI, it’s time to discuss the findings with the patient. This might be difficult as it’s tough to picture the spinal vertebrae and how they work. But if you present your patient with a detailed model of the spine that they can observe, touch, and manipulate, chances are that their understanding of compression fractures will be more complete once you’ve finished your explanation.
The best tool for this kind of education is a spine model manufactured by Dynamic Disc Designs, manufactured with exactly this type of scenario in mind. Dr. Jerome Fryer designed these lumbar models specifically so that patients could get a good grasp on a variety of spine-related conditions such as compression fractures, and doctors who use them report that patients do indeed understand once they “see” the spine. Once the patient understands, you can use ddd models to explain treatment, which may or may not be surgical, and what happens afterwards.
“While I have used many models for patient teaching over the years, [Dynamic Disc Design] models are so much more accurate and realistic. The dynamic design allows the patients to understand the pathology of disc herniation very clearly. I strongly recommend these models for patient education and surgical consent discussions.”
– Ali Moshirfar, MD, Orthopaedic and Spine Surgery Institute, Virginia, USA