Osteoporotic vertebral fracture: the sudden pain that is not lumbago
Diagnosis and treatment of fragility fractures in Valencia — from the brace to percutaneous vertebral augmentation.
A sudden, intense back pain in a person over 60–65 —sometimes after a minimal effort, a sneeze or even with no apparent cause— is not always lumbago: it may be a fragility vertebral fracture, the most frequent complication of osteoporosis. Many go undiagnosed, leaving chronic pain and loss of height that were preventable.
How to suspect it
Acute localized pain
In the dorsal or lumbar area, worse standing and on loading, better lying down.
Identifiable onset
A wrong move, a minor fall, lifting weight… or nothing at all.
Loss of height
Several accumulated fractures reduce stature and curve the back (kyphosis).
Risk factors
Known osteoporosis, prolonged corticosteroids, previous wrist or hip fracture.
Diagnosis
The X-ray identifies the vertebral collapse; the MRI distinguishes a recent fracture (with edema, potentially treatable with augmentation) from an old, already-consolidated one, and rules out other causes. Bone densitometry quantifies the underlying osteoporosis, which must always be treated.
Treatment
1. Conservative (first line). Effective analgesia, temporary support brace and progressive return to activity. Most fractures consolidate within 6–12 weeks. Prolonged bed rest is counterproductive: it accelerates bone and muscle loss.
2. Percutaneous vertebral augmentation. When pain is disabling and does not subside within 2–4 weeks, or the fracture progresses, percutaneous vertebral augmentation (vertebroplasty/kyphoplasty) stabilizes the vertebra by injecting bone cement through a cannula, with millimetric incisions and usually as day surgery or one overnight stay. Pain relief is often rapid.
3. Treating the osteoporosis: essential. After a fragility fracture, the risk of suffering another multiplies. Medical treatment of osteoporosis (together with vitamin D, weight-bearing exercise and fall prevention) is as important as treating the current fracture. We coordinate this part with your doctor or rheumatologist.
Frequently asked questions
No: most consolidate with conservative treatment. Augmentation is reserved for refractory pain or progression of the collapse.
In expert hands and with continuous radiological control it is a low-aggression procedure. As with any technique, it requires correct indication and execution.
Kyphoplasty can partially recover vertebral height if performed early; preventing new fractures is the best strategy to avoid losing further height.
Sudden back pain from age 60–65?
A vertebral fracture treated in time prevents chronic pain and deformity. Dr. Vilatela reviews your case with recent imaging in private consultation in Valencia.