General information
Vertebral body fractures, which are caused by osteoporosis, are called sinter fractures. This is a subsidence of the front edge of the vertebral body due to a minimal mechanical force applied to very soft and pre-damaged bone. Since this type of fracture can only occur in already broken bone, it belongs to the group of pathological fractures.
Cause
Vertebral body fractures, which are caused by insufficient bone mass, are generally less dramatic than trauma-related vertebral body fractures. If a vertebral body is fractured in an accident, the bone often bursts or splinters due to its strength. Accordingly, significantly greater forces are required to break a young, healthy bone.
Osteoporosis and thus soft bones, however, only lead to a subsidence of the vertebral body. However, the osteoporotic fracture can be triggered by even the smallest mechanical forces. In some cases, even a vigorous nose blowing can lead to an injury of the vertebral body.
Ultimately, the loss of bone substance primarily causes a loss of height. A wedge-shaped vertebra is formed, the trailing edge of which remains intact. For this reason, fragments usually do not enter the spinal canal.
The probability of neurological symptoms, such as a paraplegic syndrome, is therefore low. In many cases, these wedge vertebrae do not occur individually, but several times in a row. As a result of these wedges, the spinal column begins to curve forward (hyperkyphosis), and the body height decreases. Sintering fractures are always called pathological fractures, since a healthy bone must not yield in this way.
Symptoms
On the one hand, the loss of height results in an unequal proportion of torso to leg length. The curvature of the thoracic spine leads to a bulging of the abdomen. In slender patients, skin folds develop on the flanks due to the decreasing length of the torso.
These run from the back-up to the front-down. The entire appearance is colloquially referred to as “widow’s hump”. The physical changes are sometimes accompanied by severe pain and significant movement restrictions.
In many cases, affected patients regard this as a normal symptom of old age. The pain combined with the change in external appearance and the movement restrictions represent the final stage of an osteoporotic vertebral body fracture and is often seen in practice. In any case, an attempt should always be made to mobilize the patient again as quickly as possible in the event of such a fracture event.
With the help of sufficient pain medication and an orthopedic support apparatus adapted to the patient, the mobilization should be maintained through physiotherapy. Lying for a long time without movement quickly leads to calcium loss from the bone. This becomes even softer and a further fracture can quickly follow.
One surgical option is kyphoplasty. This is a small surgical procedure. Under X-ray control, the appropriate vertebral body is located and through a small incision through the working channel bone cement is injected into the vertebral body.
This hardens and partially straightens the vertebral body. If this procedure is applicable, a rapid improvement in symptoms can be expected. However, in order to prevent osteoporotic fractures of the vertebral body, medication must be used in the long term. Here, bisphosphonates are the therapy of choice. A balanced calcium balance and exercise are also important to prevent further fractures and to strengthen the bone substance.
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