What is the prognosis for vertebral compression fractures caused by osteoporosis?

Updated: Sep 26, 2019
  • Author: Monique Bethel, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Vertebral compression fractures (see the images below) are associated with increased morbidity and mortality rates. In addition, the impact of vertebral fractures increases as they increase in number. As posture worsens and kyphosis progresses, patients experience difficulty with balance, back pain, respiratory compromise, and an increased risk of pneumonia. Overall function declines, and patients may lose their ability to live independently.

Osteoporosis. Lateral radiograph demonstrates mult Osteoporosis. Lateral radiograph demonstrates multiple osteoporotic vertebral compression fractures. Kyphoplasty has been performed at one level.
Osteoporosis. Lateral radiograph of the patient se Osteoporosis. Lateral radiograph of the patient seen in the previous image following kyphoplasty performed at 3 additional levels.

In one study, Cooper et al found that vertebral fractures increased the 5-year risk of mortality by 15%. [76] In a subsequent study, Kado et al [77] demonstrated that women with one or more fractures had a 1.23-fold increased age-adjusted mortality rate and that women with 5 or more vertebral fractures had a 2.3-fold increased age-adjusted mortality rate.

Furthermore, the mortality rate correlated with number of vertebral fractures: there were 19 deaths per 1000 woman-years in women with no fracture, versus 44 per 1000 woman-years in women with five or more fractures. Vertebral fractures related to risk of subsequent cancer and pulmonary death, and severe kyphosis was further correlated with pulmonary deaths.

Symptoms of vertebral fracture may include back pain, height loss, and disabling kyphosis. Compression deformities can lead to restrictive lung disease, abdominal pain, and early satiety.


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