Poor treatment for common vertebral compression fractures

The advice and treatment given to patients with vertebral compression fractures is not satisfactory.

A thesis presented at the Sahlgrenska Academy, University of Gothenburg, Sweden, shows that the majority of patients still have severe pain one year after the fracture.

Vertebral compression fracture describes the pressing together of a vertebra in the spine such that its height is decreased. Approximately 15,000 patients suffer from vertebral compression fractures in Sweden each year, most of these caused by osteoporosis. The fracture that arises is treated with analgesics, and the patients are advised about exercise.

"The patients are told that the prognosis is good and that most people get better after a few months, but no-one has actually investigated the prognosis and course of such acute compression fractures", says Professor Tommy Hansson who was supervisor for the thesis.

The author of the thesis, research student Nobuyi Suzuki, returned to Japan immediately after the disputation.

The thesis shows that reality is quite different for patients with vertebral compression. The study followed 107 men and women in Gothenburg for one year after they had been admitted to hospital with a vertebral compression fracture. Once the initial period of acute pain had passed, the patients' condition improved somewhat, but many subsequently deteriorated. Over two thirds had intense pain or very intense pain one year after the injury. This degree of pain is fully comparable with that experienced by patients with lumbar disc herniation immediately before undergoing surgery.

"The thesis shows clearly that the treatment and advice that is given to patients with an acute vertebral compression fracture is far from satisfactory. We must develop new methods for l investigating and treating these patients", says Tommy Hansson.

Osteoporosis causes a reduction in the strength of the skeleton making it much easier for a person with osteoporosis to suffer from fractures. The most common fractures occur in the vertebrae, hip and wrist. Osteoporosis is more than twice as common in women than it is in men, and a middle-aged woman has a 50% risk of suffering a fracture caused by osteoporosis in her remaining years.