関: spinal compression fracture

WordNet

interrupt, break, or destroy; "fracture the balance of power"
breaking of hard tissue such as bone; "it was a nasty fracture"; "the break seems to have been caused by a fall" (同)break
fracture a bone of; "I broke my foot while playing hockey" (同)break
become fractured; "The tibia fractured from the blow of the iron pipe"
break (a bone); "She broke her clavicle"
break into pieces; "The pothole fractured a bolt on the axle"
violate or abuse; "This writer really fractures the language"
the act of cracking something (同)crack, cracking
applying pressure (同)compressing
encoding information while reducing the bandwidth or bits required
the process or result of becoming smaller or pressed together; "the contraction of a gas on cooling" (同)condensation, contraction
of or relating to or constituting vertebrae
one of the bony segments of the spinal column

PrepTutorEJDIC

〈U〉(特に)骨を折ること;骨を折った状熊 / 〈C〉割れ(裂け)目,(鉱物の)破砕面 / 〈足・腕などを〉‘を'骨折する;…‘を'砕く / 骨折する;砕ける
圧搾,圧傷;要約
脊椎骨の;脊椎骨から成る
脊椎骨

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/03/30 09:57:34」(JST)

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A compression fracture is a collapse of a vertebra. It may be due to trauma or due to a weakening of the vertebra (compare with burst fracture). This weakening is seen in patients with osteoporosis or osteogenesis imperfecta, lytic lesions from metastatic or primary tumors,^[1] or infection.^[2] In healthy patients it is most often seen in individuals suffering extreme vertical shocks, such as ejecting from an ejection seat. Seen in lateral views in plain x-ray films, compression fractures of the spine characteristically appear as wedge deformities, with greater loss of height anteriorly than posteriorly and intact pedicles in the anteroposterior view.^[3]

Symptoms

Acute fractures will cause severe back pain. Compression fractures which develop gradually, such as in osteoporosis, may initially not cause any symptoms, but will later often lead to back pain and loss of height.

Diagnosis

Compression fractures are usually diagnosed on spinal radiographs, where a wedge-shaped vertebra may be visible or there may be loss of height of the vertebra. In addition, bone density measurement may be performed to evaluate for osteoporosis. When a tumor is suspected as the underlying cause, or the fracture was caused by severe trauma, CT or MRI scans may be performed.

Compression fracture of the fourth lumbar vertebra post falling from a height.
X-ray of the lumbar spine with a compression fracture of the third lumbar vertebra.

Treatment

Conservative treatment

Back brace for support while the bone heals - either a Jewett brace for relatively stable and mild injuries, or a TLSO for more severe ones.^[4]
Opioids or Non-steroidal anti-inflammatory drugs for pain. For osteoporotic patients, Calcitonin may be helpful.^[5]^[6]

Surgical

Kyphoplasty^[7] and vertebroplasty,^[7]^[8] minimally invasive procedures that inject cement into the bone of the back are treatment options. There is conflicting data however about the effectiveness of these procedures.^[9]^[10]^[11]^[12]^[13]

References

^ Weber, Kristy (February 28, 2006). "Rounds 2: Treatment of Metastatic Bone Disease". John Hopkins Arthritis Center.
^ "Bone Infections". MedlinePlus. September 7, 2011.
^ Brant, William E.; Helms, Clyde A. (2007). "Benign Compression Fracture". Fundamentals of Diagnostic Radiology (3rd ed.). Philadelphia: Lippincott Williams & Wilkins. p. 302. ISBN 978-0-7817-6135-2.
^ "Jewett vs. TLSO Replies". OANDP-L on oandp.com. 2010-09-27. Retrieved 2012-09-02.
^ "Calcitonin for osteoporotic fractures". Retrieved 2012-09-03.
^ Knopp, Jennifer A.; Diner, Barry M.; Blitz, Maurice; Lyritis, George P.; Rowe, Brian H. (2004). "Calcitonin for treating acute pain of osteoporotic vertebral compression fractures: A systematic review of randomized, controlled trials". Osteoporosis International 16 (10): 1281–90. doi:10.1007/s00198-004-1798-8. PMID 15614441.
^ ^a ^b Taylor, Rod S.; Taylor, Rebecca J.; Fritzell, Peter (2006). "Balloon Kyphoplasty and Vertebroplasty for Vertebral Compression Fractures". Spine 31 (23): 2747–55. doi:10.1097/01.brs.0000244639.71656.7d. PMID 17077747.
^ Taylor, Rod S.; Fritzell, Peter; Taylor, Rebecca J. (2007). "Balloon kyphoplasty in the management of vertebral compression fractures: An updated systematic review and meta-analysis". European Spine Journal 16 (8): 1085–100. doi:10.1007/s00586-007-0308-z. PMC 2200787. PMID 17277923.
^ Kallmes, David F.; Comstock, Bryan A.; Heagerty, Patrick J.; Turner, Judith A.; Wilson, David J.; Diamond, Terry H.; Edwards, Richard; Gray, Leigh A. et al. (2009). "A Randomized Trial of Vertebroplasty for Osteoporotic spinal Fractures". New England Journal of Medicine 361 (6): 569–79. doi:10.1056/NEJMoa0900563. PMC 2930487. PMID 19657122.
^ Buchbinder, Rachelle; Osborne, Richard H.; Ebeling, Peter R.; Wark, John D.; Mitchell, Peter; Wriedt, Chris; Graves, Stephen; Staples, Margaret P.; Murphy, Bridie (2009). "A Randomized Trial of Vertebroplasty for Painful Osteoporotic Vertebral Fractures". New England Journal of Medicine 361 (6): 557–68. doi:10.1056/NEJMoa0900429. PMID 19657121.
^ Boonen, S.; Wahl, D. A.; Nauroy, L.; Brandi, M. L.; Bouxsein, M. L.; Goldhahn, J.; Lewiecki, E. M.; Lyritis, G. P. et al. (2011). "Balloon kyphoplasty and vertebroplasty in the management of vertebral compression fractures". Osteoporosis International 22 (12): 2915–34. doi:10.1007/s00198-011-1639-5. PMID 21789685.
^ Han, Shiliang; Wan, Shuanglin; Ning, Lei; Tong, Yongjun; Zhang, Jianfeng; Fan, Shunwu (2011). "Percutaneous vertebroplasty versus balloon kyphoplasty for treatment of osteoporotic vertebral compression fracture: A meta-analysis of randomised and non-randomised controlled trials". International Orthopaedics 35 (9): 1349–58. doi:10.1007/s00264-011-1283-x. PMC 3167445. PMID 21637959.
^ Farrokhi, Majid Reza; Alibai, Ehsanali; Maghami, Zohre (2011). "Randomized controlled trial of percutaneous vertebroplasty versus optimal medical management for the relief of pain and disability in acute osteoporotic vertebral compression fractures". Journal of Neurosurgery: Spine 14 (5): 561–9. doi:10.3171/2010.12.SPINE10286. PMID 21375382.

External links

Vertebral Compression Fracture information on eMedicineHealth
Zeller, J. L.; Burke, A. E.; Glass, R. M. (2008). "Osteomyelitis". JAMA 299 (7): 858. doi:10.1001/jama.299.7.858. PMID 18285597.
Medscape article on lytic lesions
Emedicine article on spinal metastasis

UpToDate Contents

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1. 骨粗鬆症による胸腰椎圧迫骨折：臨床症状および医療 osteoporotic thoracolumbar vertebral compression fractures clinical manifestations and treatment
2. 成人における脊髄損傷：定義、機序、および放射線学的所見 spinal column injuries in adults definitions mechanisms and radiographs
3. ニ重エネルギーX線吸収測定の概要 overview of dual energy x ray absorptiometry
4. 小児または思春期のアスリートにおける頸部の筋骨格損傷の概要 overview of musculoskeletal neck injuries in the child or adolescent athlete
5. 癌疼痛のマネージメント：介入的治療 cancer pain management interventional therapies

English Journal

In silico evaluation of stress distribution after vertebral body augmentation with conventional acrylics, composites and glass polyalkenoate cements.

Dickey BT, Tyndyk MA, Doman DA, Boyd D.SourceSchool of Biomedical Engineering, Dalhousie University, Halifax, Canada.
Journal of the mechanical behavior of biomedical materials.J Mech Behav Biomed Mater.2012 Jan;5(1):283-90. Epub 2011 Aug 24.
There exists clinical evidence of fractures in adjacent vertebrae subsequent to vertebral augmentation procedures, such as vertebroplasty (VP) and kyphoplasty (KP). A potential contributory factor to such fractures may be the excessive mismatch of mechanical properties between contemporary bone ceme
PMID 22100103

Cement leakage as a possible complication of balloon kyphoplasty-is there a difference between osteoporotic compression fractures (AO type A1) and incomplete burst fractures (AO type A3.1)?

Walter J, Haciyakupoglu E, Waschke A, Kalff R, Ewald C.SourceDepartment of Neurosurgery, Jena University Hospital, Friedrich Schiller University Jena, Erlanger Allee 101, 07747, Jena, Germany, jan.walter@med.uni-jena.de.
Acta neurochirurgica.Acta Neurochir (Wien).2011 Dec 8. [Epub ahead of print]
BACKGROUND: Besides the treatment of osteoporotic vertebral compression fractures of AO type A1, balloon kyphoplasty (BKP) is seen as a therapeutic option even in the treatment of incomplete osteoporotic burst fractures (AO type A3.1). However, due to involvement of the posterior vertebral body wall
PMID 22146845