Osteoporotic Vertebral Compression Fractures (VCF)
Osteoporotic VCFs are common and under-recognized. Care integrates fracture classification, acuity assessment (STIR/T2 edema), analgesia and bracing, fall-risk mitigation, and timely augmentation in selected cases while aggressively treating the underlying osteoporosis.
Imaging Gallery
Before/after balloon kyphoplasty. Source: Wikimedia Commons (CC BY 4.0; © Rei Momomura).
Post-kyphoplasty lateral radiograph. Source: Wikimedia Commons (CC BY 3.0; © Dirk69CS).
Fluoroscopy prior to cement injection. Source: Wikimedia Commons (CC BY 4.0; © Jmarchn).
Fluoroscopy after cement augmentation. Source: Wikimedia Commons (CC BY 4.0; © Jmarchn).
Instrumentation principles apply when long constructs are needed for severe deformity or nonunion. Source: Wikimedia Commons (CC BY 4.0).
Use dermatomal maps to distinguish radicular pain from fracture-related axial pain. Source: Wikimedia Commons (Public Domain).
Posterior dermatomes for sensory correlation. Source: Wikimedia Commons (Public Domain).
Practical Management
- Confirm acuity: MRI STIR edema indicates recent fracture; evaluate for posterior wall retropulsion and canal compromise.
- Analgesia and bracing: short-term TLSO for comfort; mobilize early; avoid prolonged bedrest.
- Osteoporosis therapy: vitamin D, calcium; initiate anabolic or antiresorptive therapy per DEXA and risk; coordinate endocrinology.
- Augmentation: consider kyphoplasty/vertebroplasty for severe pain refractory to optimal medical care; evaluate cement leakage risk.
- Deformity and nonunion: consider longer constructs and cement-augmented fixation in poor bone.
You can contact us at @bdthombre(https://www.linkedin.com/in/bdthombre/Â ) on LinkedIn.