Many patients ask me what is the most missed, under diagnosed and un-treated condition in my field. My answer without hesitation is Vertebral Compression Fracture (VCF).
Why? Because of the performance gap in recognition. I spend a great deal of my time reminding providers about osteoporosis screening, treatment and complications. Osteoporosis affect 200 million women and causes 700,000 spinal fractures in the US each year.
VCF is the most common osteoporotic fracture and up to 2/3 are undiagnosed. One it occurs there is a 5 – fold in increase in another fracture in 1 year.
Normal Bone under a microscope is much different when compared to osteoporotic bone. When this bone begins to weaken the vertebral body can compress and usually deforms in such a way that causes what looks like a wedge in the front of the vertebral body. On the outside of the body this looks like a “hump” and loss of height. Mostly likely, you have seen this before.
Eventually this will cause what has been described as a downward spiral.
The goal is to recognize, diagnose and treat this condition before it’s too late. You may have seen these signs before, but the solution is actually quite simple in a physician that has been well trained.
Common Signs:
Sudden onset of back pain
Loss of height
Kyphosis
Activity related pain
Pain disappears when lying down
Tenderness of back of spine
This procedure can usually be performed in the clinic in our outpatient surgery setting. Patients go home the same day and usually report a significant drop in pain.
Prevention:
Bone Denisity (DXA) Scan
Evaluation for secondary causes
Risk Reduction
Calcium and Vitamin D Supplementation
Appropriate Exercise
