Compression Fractures of the Lumbar Spine
The lumbar spine is comprised of the five largest and strongest of all
the vertebrae in the spine. The strongest stabilizing muscles of the spine
are attached to the lumbar vertebrae therefore fractures of the lumbar
vertebrae usually occur due to either trauma, weakening of the bone, or
another underlying cause.
The trauma usually necessary to break the bones of this area of the spine
is quite significant and may be the result of a fall in which a person
lands on their feet or buttocks, a car accident in which other injuries
may be present or in contact sports injuries. However, in the case of
the elderly or in people with cancer, these bones can break with little
or no force. Such is the case in people with
osteoporosis commonly occurring in postmenopausal women or elderly men. Long term use
of steroid medication such as prednisone can also cause loss of bone density
making these people at risk for compression fractures. In the instance
of a pathological fracture, there is a preexisting disease at the fracture
site such as cancer in the bone that has traveled from other parts of the body.
Symptoms of a lumbar compression fracture may include:
- Pain in the lower back
- Possible pain in the hip, abdominal area or in the thigh.
- Numbness, tingling and weakness (due to compression of the nerves)
- Loss of bladder or bowel control or inability to urinate.
Diagnosis of a compression fracture begins with obtaining the patient's
complete medical history. Unless evident, your doctor will want to know
any recent injuries or activities that could of led to the fracture. It
is important to know when the pain started and if it was sudden or gradual,
the location and intensity of the pain. Whether or not different activities
or positions make the patient feel better or worse and if the pain is
radiating to the extremities or other parts of the body?
A physical examination will also be done to rule out other possible underlying
problems. The doctor will also check to see if there is tenderness or
sensitivity near specific areas of the spine. If a compression fracture
is suspected, an
X-ray, CT scan, MRI or a combination there of may be ordered to confirm the diagnosis as well
as check for other issues that may be present.