OSTEOPOROTIC COMPRESSION FRACTURE: SALIENT POINTS

*most common spine fracture in the emergency dept.

* female > male

* sudden onset pain in midback after a simple maneuvre such as coughing or lifting of weight

* 20% have asymptomatic fracture

* neurological deficit is rare after simple compression fracture

* 3 patterns of fracture ---> wedge, codfish and vertebra plana type

* CT should be taken if middle column involvement is suspected

* suspect burst fracture if interpedicular distance is increased or posterior vertebral height is decreased

* Admission if: severe pain ileus urinarty retention neurological comlications

* Bracing is offered to patient and he is then mobilised

* BMD is must for all osteoporotic fractures and approprite treatment is then instituted

* brace for 6-12 weeks

* after that----> extension exercise programme and low impact aerobics

* If significant pain after a few weeks---->Vertebroplasty is a good option

* Kyphotic deformity aftre repeated compression fractures---->ribs impinge on the pelvis,poor posture, protuberant abdomen, respiratory compromise.