Vertebral Compression Fracture
A collapse of a vertebral body, most often caused by osteoporosis
A vertebral compression fracture (VCF) occurs when a vertebral body — one of the bony building blocks of the spine — collapses or cracks. They are most commonly caused by osteoporosis, where weakened bones fracture with minimal force, sometimes from a sneeze, a minor fall, or even just bending forward. VCFs can also result from trauma or spinal tumors. An estimated 700,000 osteoporotic vertebral compression fractures occur in the United States each year, making them more common than hip fractures.
Symptoms
- Sudden, severe back pain — often described as a "snap" followed by acute pain
- Pain that worsens with standing, walking, or bending forward
- Pain that improves when lying down and resting
- Height loss of 1–2 inches or more over time with multiple fractures
- A hunched posture or visible rounding of the upper back (kyphosis/dowager's hump)
- Limited spinal flexibility and mobility
- In severe cases: neurological symptoms if the fracture impinges on the spinal cord or nerves
Causes & Risk Factors
- Osteoporosis — the most common cause; bones become porous and weak
- Trauma such as a car accident, fall from height, or sports injury
- Spinal metastases — cancer that has spread to the vertebral body
- Prolonged corticosteroid use (prednisone) accelerating bone density loss
- Aging, menopause, and hormonal changes reducing bone density
- Nutritional deficiencies in calcium and vitamin D
- Excessive alcohol use and smoking damaging bone health
Treatment Options
Conservative (Non-Surgical)
- Pain medications — NSAIDs, acetaminophen, or short-term opioids for acute fracture pain
- Rest and activity modification during the acute healing phase
- Spinal bracing (TLSO brace) to support the fractured vertebra and reduce pain
- Physical therapy — gentle mobilization followed by back-strengthening and balance exercises
- Osteoporosis treatment: bisphosphonates (alendronate, zoledronic acid), denosumab, or teriparatide
- Calcium and vitamin D supplementation to support bone healing and prevent future fractures
- Fall prevention strategies and home safety evaluation
Surgical Options
- Kyphoplasty — a balloon is inserted into the fractured vertebra to restore height, then bone cement is injected to stabilize it; the most common procedure
- Vertebroplasty — bone cement is injected directly into the fractured vertebra without balloon height restoration
- Spinal fusion surgery for unstable fractures causing neurological compromise
When to see a spine specialist
See a physician promptly if you experience sudden back pain, especially if you are over 50 or have a history of osteoporosis. Any back pain accompanied by leg weakness, numbness, or loss of bladder/bowel control requires emergency evaluation. Untreated VCFs can lead to progressive deformity and additional fractures.
Frequently Asked Questions
Can a vertebral compression fracture heal on its own?
Yes — many VCFs heal with conservative treatment (rest, bracing, pain management) within 6–12 weeks. The vertebral body often stabilizes as the fracture heals, though some height loss may be permanent. However, in older adults with osteoporosis, healing can be slower, and the risk of additional fractures at adjacent vertebrae is significant without treating the underlying osteoporosis.
What is the difference between kyphoplasty and vertebroplasty?
In vertebroplasty, bone cement is injected directly into the fractured vertebra to stabilize it. In kyphoplasty, a small balloon is first inserted and inflated to try to restore the vertebral height before cement is injected. Kyphoplasty can reduce pain faster and may partially correct spinal deformity, but both procedures have similar long-term pain outcomes. Your spine surgeon will recommend based on how recent the fracture is and the degree of collapse.
How can I prevent another vertebral compression fracture?
Treating the underlying cause is essential. For osteoporotic fractures: work with your physician to start bone-strengthening medications, ensure adequate calcium and vitamin D intake, and eliminate fall risks in your home. Weight-bearing exercise (walking, strength training) improves bone density over time. Avoid smoking and excess alcohol. If you had a fracture with minimal or no trauma, a bone density scan (DEXA) and endocrine evaluation should be part of your follow-up care.
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Medical disclaimer: This content is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider for diagnosis and treatment decisions. Last reviewed March 2026. ICD-10: M80.08XA.