Osteoporotic Compression Fractures

Osteoporotic compression fractures occur when weakened vertebrae collapse due to reduced bone density, most commonly in older adults and postmenopausal women. These spinal fractures can lead to significant pain, reduced mobility, and, in severe cases, neurological symptoms.

Effective management involves accurate diagnosis, conservative treatment or surgical intervention when necessary, and addressing the underlying osteoporosis to support long-term spinal health.

What is Osteoporosis?

Osteoporosis is a metabolic disorder characterized by low bone density. It typically occurs in the elderly and female gender due to hormonal changes. However, it may also occur in younger patients with other underlying conditions or on chronic medications such as steroids.

The low bone density predisposes to spine vertebral fractures. These can occur from a fall from standing height or even during routine activities.

Symptoms of Osteoporotic Compression Fractures

Patients with osteoporotic compression fractures may experience a range of symptoms depending on the severity of the fracture and the extent of spinal involvement:

• Severe pain due to the instability of the fracture
• Progressive deformity with a stooped appearance and loss of height
• Limited mobility of the spine
• Compression of nerve roots by bone fragments may cause severe shooting pain which travels down the buttocks into the leg of the affected side. (commonly referred to as Sciatica)
• Compression of the spinal canal by retropulsed bone may cause vague dull aches within the lower limbs which worsen in relation to exertion. (commonly referred to as Claudication)
• Symptoms of weakness and numbness in the lower limbs may arise when nerves are severely restricted.
• On occasion, this can even lead to permanent loss of bladder and bowel control.

Diagnosing Osteoporotic Compression Fractures

It is important to rule out other dangerous conditions that may weaken the bone and predispose to the development of fractures.

Dr Mark Tan BH conducts a thorough evaluation that includes:

• Thorough clinical and medical history
• Complete physical examination including the testing of individual nerves

Depending on the results of the interview and physical examination, Dr Mark Tan BH may require further tests to delineate the extent of your condition.

• Blood investigations
• Radiographs
• Bone mineral density measurements
• MRI Scans

Conservative Treatment for Osteoporotic Fractures

In most cases, osteoporotic compression fractures can be treated without surgery. Conservative management focuses on stabilising the spine and relieving pain:

• Oral analgesia to relieve pain
• Bracing to prevent further instability and collapse of the fracture
• Physiotherapy to return the patient to function.
• It is also important that the underlying osteoporosis is evaluated and treated. This can be achieved with calcium and vitamin D supplementation, physical activity, oral bisphosphonates or subcutaneous injections depending on your pre-existing conditions.

Surgical Treatment Option

Surgical treatment may be recommended when:

• Failure of conservative management
• Intractable pain despite oral medication
• Development of neurological symptoms

Treatment options include:

• Vertebroplasty: This is a minimally-invasive percutaneous technique in which low viscosity cement is injected via a small needle into the fractured vertebra thus augmenting the bone and reducing pain.

• Kyphoplasty: This procedure is similar to vertebroplasty. Prior to injection to the cement, small balloons are inflated within the vertebral body to restore its height and create a space for the cement to fill.

• Surgical Fixation and Decompression: This is reserved for cases which show progressive collapse and pain, with the development of neurological symptoms. Screws may be inserted with CT-guidance and augmented with cement to prevent implant loosening.

Getting the Right Care

Dr Mark Tan BH offers personalised, evidence-based spine care for patients with osteoporotic compression fractures in Singapore. By addressing both the fracture and the underlying bone health, he supports long-term recovery and quality of life.

Schedule a spinal consultation to discuss your treatment options.