Compression Fractures

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Dr Kau Chung Yuan (许医生)


MRCS (Ireland)

MMed (Ortho)

FRCSEd (Ortho)


What are Compression Fractures?

Compression fractures refer to a specific type of bone injury, predominantly affecting the vertebrae within the spine. These fractures are characterised by the collapsing of the bone onto itself, which usually results from a reduction in bone strength or density.

Although compression fractures can occur in any part of the spine, they are most frequently observed in the thoracic region (the mid-back) and the upper lumbar region (the lower back).


Compression fractures often result from conditions that weaken the bone structure, increasing the susceptibility of the vertebrae to collapse under normal pressure.

  • Osteoporosis
    This is the most prevalent cause of compression fractures. Osteoporosis leads to decreased bone density and quality, rendering bones more fragile and prone to fractures even with minimal stress. It primarily affects older adults, particularly postmenopausal women.
  • Trauma
    Compression fractures can also result from traumatic events such as falls, forceful jumps, or car accidents. In younger individuals without bone density issues, these high-impact events can lead to compression fractures.
  • Pathological Fractures
    These fractures occur due to pathological changes within the bone, often associated with cancer or other diseases that weaken the bone structure.
  • Steroid Use and Other Risk Factors
    Long-term use of corticosteroids can lead to reduced bone density, increasing the risk of compression fractures. Additional risk factors include certain medical conditions, lifestyle choices, and genetic predispositions impacting bone health.


The symptoms of compression fractures can vary depending on the severity and location of the fracture, but some common signs are often present.

  • Pain
    The most immediate and noticeable symptom is pain. This pain can be sharp and disabling, especially just after the fracture occurs. It is typically localised in the back at the site of the fracture but can radiate to other areas.
  • Decreased Mobility
    Individuals with a compression fracture may experience reduced mobility due to pain and stiffness in the spine.
  • Height Loss
    Over time, multiple compression fractures can lead to a noticeable loss in height as the vertebrae become compressed.
  • Postural Changes
    A stooped posture, often referred to as a “dowager’s hump,” can develop, particularly if there are multiple thoracic fractures.
  • Other Symptoms
    In severe cases, compression fractures can lead to more serious complications such as difficulty breathing, digestive issues, and changes in bowel or bladder function due to nerve compression.


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Diagnosing a compression fracture involves a combination of clinical assessment and imaging studies.

Medical History and Physical Examination

The initial step is a thorough medical history and physical examination. The orthopaedic surgeon will enquire about symptoms, any recent injuries, risk factors for osteoporosis, and overall health status. During the physical examination, the orthopaedic surgeon will look for tenderness over the spine and assess the range of motion and neurological function.

Imaging Tests
  • X-rays: These are often the first imaging tests done. An X-ray can show the structure of the vertebrae and the outline of the joints. Fractures can usually be seen clearly on an X-ray.
  • Magnetic Resonance Imaging (MRI): MRI is used when more detail is needed or if there is a suspicion of a recent fracture that does not show up on an X-ray. MRI can also identify whether a fracture is old or new and detect changes in soft tissues, including the intervertebral discs and spinal cord.
  • Computed Tomography (CT) Scan: A CT scan can provide detailed images of bone and can identify subtle or complex fractures that may not be visible on an X-ray.
Bone Density Testing

This test is particularly important for patients suspected of having osteoporosis-related compression fractures. It measures the density of the bones and helps assess the risk of future fractures.

Non-Surgical Treatment Options

The primary goals of non-surgical treatment are to manage pain, stabilise the fracture, and prevent future fractures.

  • Pain Management: This typically involves the use of medications. Over-the-counter pain relievers like acetaminophen (Tylenol) may be recommended. In some cases, stronger prescription pain medications or muscle relaxants might be necessary.
  • Activity Modification: Patients are often advised to modify their activities to avoid movements that exacerbate pain or put additional stress on the spine.
  • Bracing: A brace can be used to support the spine and limit movement, allowing the fracture to heal. It also helps in reducing pain and correcting posture.
  • Physical Therapy: Physical therapy plays a key role in recovery. It includes exercises to strengthen the back muscles, improve posture, and increase flexibility, which can help support the spine and reduce the risk of future fractures.
  • Osteoporosis Treatment: If the compression fracture is due to osteoporosis, treating the underlying osteoporosis is important to prevent future fractures. This may include medications that strengthen bones, dietary changes, and supplements like calcium and vitamin D.

Surgical Treatment Options

In cases where non-surgical treatments are not effective or when the compression fracture leads to severe symptoms, surgical options may be considered. These procedures aim to reduce pain, stabilise the fracture, and restore the height or alignment of the vertebra.

  • Vertebroplasty
    This minimally invasive procedure involves the injection of a special cement into the fractured vertebra. The cement hardens and stabilises the fracture, which helps to reduce pain. Vertebroplasty is usually done under local anaesthesia and sedation.
  • Kyphoplasty
    Similar to vertebroplasty, kyphoplasty involves the insertion of a balloon into the vertebra before injecting the cement. The balloon is inflated to create space and restore some of the height lost due to the fracture, after which it is deflated and removed, and the space is filled with cement.
  • Spinal Fusion Surgery
    In more severe cases, particularly when there is spinal instability, spinal fusion surgery might be necessary. This involves joining two or more vertebrae together using bone grafts and metal rods or screws. This procedure can provide significant pain relief and stabilise the spine but is more invasive and has a longer recovery time.

Dr. Kau Chung Yuan

MBBS (S’pore)

MRCS (Ireland)

MMed (Ortho)

FRCSEd (Ortho)

Dr Kau (许医生) is a Fellowship trained Orthopaedic Surgeon with a subspecialty interest in Hip and Knee surgery and has been in practice for more than 15 years.

He is experienced in trauma and fracture management, sports injuries, and joint replacement surgery.

  • Fellow of the Royal College of Surgeons Edinburgh, Orthopaedics (FRCS, Edin) 2014
  • Master of Medicine (Orthopaedics), Singapore (MMed) 2013
  • Member of the Royal College of Surgeons Ireland (MRCS, Ire) 2009
  • Bachelor of Medicine and Surgery (MBBS, Singapore) 2004

Prevention Strategies

Preventing compression fractures primarily involves addressing the risk factors and underlying conditions that contribute to weakened bones. Here are key strategies:

  • Maintain Bone Health: This includes a diet rich in calcium and vitamin D, regular weight-bearing and strength-training exercises, and avoiding smoking and excessive alcohol consumption. These practices are crucial for maintaining bone density and strength.
  • Osteoporosis Screening and Treatment: Regular screening for osteoporosis, particularly for those at higher risk such as postmenopausal women and older adults, is important. If diagnosed, following a treatment plan to strengthen bones can significantly reduce the risk of fractures.
  • Medication Review: Regular review of medications with an orthopaedic surgeon can help identify drugs that may contribute to bone loss or increase the risk of falls.
  • Regular Check-Ups: Regular check-ups with an orthopaedic surgeon can help monitor bone health and address any early signs of bone density loss.

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Patient Feedback

Ethan Chan
Dr. Kau is an exemplary doctor who is experienced in his field and is very patient with his patients. He walked me through the details of my knee condition and addressed all my concerns. Thanks to Dr. Kau, I had a better understanding of my ACL and MCL injury and the various treatment options available. His advice and treatment have been very valuable to me.
Ming Lee Chua
Dr Kau was very careful and explained clearly the surgery procedures. After surgery, the care while I was in hospital was closely monitored and he even came during weekends! The hip so far has recovered and healed. His ‘predictions’ of when what can happen are so accurate. Trust him.
Teo Pek Suan Diana
I had a very successful total hip replacement done by Dr Kau 4 years ago. 4 months after the operation I was back walking, cycling and swimming. The beautiful job gave me much confidence Dr Kau is most professional and has such great doctor patient communication.

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    Frequently Asked Questions (FAQs)

    What Is the Difference Between a Compression Fracture and a Regular Bone Fracture?

    A compression fracture specifically refers to the collapse of a vertebra in the spine, whereas a regular bone fracture can occur in any bone and involves a break or crack in the bone structure.

    Can Compression Fractures Heal on Their Own?

    Many compression fractures, especially those that are mild, can heal on their own with time and conservative treatment, such as rest, pain management, and physical therapy. However, the healing process varies depending on the individual’s overall health and the severity of the fracture.

    Are There Any Long-Term Effects of a Compression Fracture?

    While many people recover fully, some may experience long-term effects such as chronic pain, decreased mobility, or postural changes. Severe fractures can lead to complications like spinal deformity or nerve damage.

    Is Surgery Always Required for Compression Fractures?

    Surgery is not always required. Many compression fractures are treated successfully with non-surgical methods. Surgery is considered when non-surgical treatments fail to relieve symptoms or when the fracture leads to severe or worsening back pain, spinal instability, or neurological symptoms.